Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease

José González-Costello, Hilary F. Armstrong, Ulrich P. Jorde, Anna C. Bevelaqua, Laurie Letarte, Byron M. Thomashow, Matthew N. Bartels

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve (%HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second (%FEV1) of 25% and median %HRR of 33%. The hazard ratio for an event in the lowest quartile of %HRR, taking the highest quartile as reference, was of 3.2 (95% confidence interval: 2.1-4.8; p<0.001). In a multivariate regression model, %HRR was an independent predictor of events. In conclusion, CI was an independent and powerful outcome predictor in patients with severe COPD.

Original languageEnglish (US)
Pages (from-to)113-118
Number of pages6
JournalRespiratory Physiology and Neurobiology
Volume188
Issue number2
DOIs
StatePublished - Aug 15 2013
Externally publishedYes

Fingerprint

Obstructive Lung Diseases
Chronic Obstructive Pulmonary Disease
Mortality
Pneumonectomy
Forced Expiratory Volume
Left Ventricular Dysfunction
Exercise Test
Heart Rate
Confidence Intervals
Transplants
Lung

Keywords

  • Chronic obstructive pulmonary disease
  • Chronotropic incompetence
  • Heart rate reserve

ASJC Scopus subject areas

  • Physiology
  • Pulmonary and Respiratory Medicine
  • Neuroscience(all)

Cite this

Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease. / González-Costello, José; Armstrong, Hilary F.; Jorde, Ulrich P.; Bevelaqua, Anna C.; Letarte, Laurie; Thomashow, Byron M.; Bartels, Matthew N.

In: Respiratory Physiology and Neurobiology, Vol. 188, No. 2, 15.08.2013, p. 113-118.

Research output: Contribution to journalArticle

González-Costello, José ; Armstrong, Hilary F. ; Jorde, Ulrich P. ; Bevelaqua, Anna C. ; Letarte, Laurie ; Thomashow, Byron M. ; Bartels, Matthew N. / Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease. In: Respiratory Physiology and Neurobiology. 2013 ; Vol. 188, No. 2. pp. 113-118.
@article{68d2a755777446fdb2636cf5b88e71cd,
title = "Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease",
abstract = "We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve ({\%}HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second ({\%}FEV1) of 25{\%} and median {\%}HRR of 33{\%}. The hazard ratio for an event in the lowest quartile of {\%}HRR, taking the highest quartile as reference, was of 3.2 (95{\%} confidence interval: 2.1-4.8; p<0.001). In a multivariate regression model, {\%}HRR was an independent predictor of events. In conclusion, CI was an independent and powerful outcome predictor in patients with severe COPD.",
keywords = "Chronic obstructive pulmonary disease, Chronotropic incompetence, Heart rate reserve",
author = "Jos{\'e} Gonz{\'a}lez-Costello and Armstrong, {Hilary F.} and Jorde, {Ulrich P.} and Bevelaqua, {Anna C.} and Laurie Letarte and Thomashow, {Byron M.} and Bartels, {Matthew N.}",
year = "2013",
month = "8",
day = "15",
doi = "10.1016/j.resp.2013.05.002",
language = "English (US)",
volume = "188",
pages = "113--118",
journal = "Respiratory Physiology and Neurobiology",
issn = "1569-9048",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease

AU - González-Costello, José

AU - Armstrong, Hilary F.

AU - Jorde, Ulrich P.

AU - Bevelaqua, Anna C.

AU - Letarte, Laurie

AU - Thomashow, Byron M.

AU - Bartels, Matthew N.

PY - 2013/8/15

Y1 - 2013/8/15

N2 - We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve (%HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second (%FEV1) of 25% and median %HRR of 33%. The hazard ratio for an event in the lowest quartile of %HRR, taking the highest quartile as reference, was of 3.2 (95% confidence interval: 2.1-4.8; p<0.001). In a multivariate regression model, %HRR was an independent predictor of events. In conclusion, CI was an independent and powerful outcome predictor in patients with severe COPD.

AB - We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve (%HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second (%FEV1) of 25% and median %HRR of 33%. The hazard ratio for an event in the lowest quartile of %HRR, taking the highest quartile as reference, was of 3.2 (95% confidence interval: 2.1-4.8; p<0.001). In a multivariate regression model, %HRR was an independent predictor of events. In conclusion, CI was an independent and powerful outcome predictor in patients with severe COPD.

KW - Chronic obstructive pulmonary disease

KW - Chronotropic incompetence

KW - Heart rate reserve

UR - http://www.scopus.com/inward/record.url?scp=84880115319&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880115319&partnerID=8YFLogxK

U2 - 10.1016/j.resp.2013.05.002

DO - 10.1016/j.resp.2013.05.002

M3 - Article

VL - 188

SP - 113

EP - 118

JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

SN - 1569-9048

IS - 2

ER -