Open AccessHeart Rate Recovery and Tissue Doppler Echocardiography in Heart Failure
Author(s) -
Guazzi Marco,
Myers Jonathan,
Ann Peberdy Mary,
Bensimhon Daniel,
Chase Paul,
Pinkstaff Sherry,
Arena Ross
Publication year - 2010
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20548
Subject(s) - medicine , cardiology , ejection fraction , heart failure , doppler imaging , proportional hazards model , population , doppler echocardiography , blood pressure , diastole , environmental health
Background Previous research has demonstrated the prognostic value of echocardiography with tissue Doppler imaging (TDI) in the heart failure (HF) population. Heart rate recovery (HRR) has also recently shown promise as a prognostic marker. Hypothesis We hypothesize echocardiography with TDI and HRR will be significantly correlated and both will provide prognostic information. Methods A total of 243 subjects underwent echocardiography with TDI and maximal exercise testing to determine: (1) the ratio between mitral early (E) to mitral annular (E′) and E to mitral late (A) velocity; (2) left ventricular ejection fraction (LVEF); (3) left ventricular (LV) mass; (4) LV end‐systolic volume (LVESV); and (5) HRR at 1 minute postexercise (HRR 1 ). Results HRR 1 was significantly correlated with LVEF ( r = 0.14, P = .03), LV mass ( r = − 0.30, P <.001), E/A ( r = − 0.22, P = .001), and E/E′ ( r = − 0.49, P <.001). Multivariate Cox regression analysis revealed HRR 1 was the strongest predictor of cardiac mortality (χ 2 : 55.5, P <.001); LV mass (residual χ 2 : 13.1, P <.001), E/E′ (residual χ 2 : 11.2, P = .001), and LVESV (residual χ 2 : 5.9, P = .015) all added significant prognostic value and were retained in the regression while LVEF was removed (residual χ 2 : 0.008, P = .93). Conclusions To our knowledge, this is the first investigation demonstrating an association between HRR and variables obtained from echocardiography with TDI in subjects with HF. The combination of both assessment techniques provides improved prognostic discrimination. Copyright © 2010 Wiley Periodicals, Inc.