Navigation Links
Heart rate recovery predicts clinical worsening in pulmonary hypertension

Heart rate recovery at one minute after a six-minute walking distance (6MWD) test is highly predictive of clinical worsening and time to clinical worsening in patients with idiopathic pulmonary arterial hypertension (IPAH), according to a new study.

"Ours is the first study to show that heart rate recovery at one minute of rest (HRR1) following a 6MW test is a strong predictor of clinical worsening in IPAH patients," said Omar A. Minai, MD, staff physician in the Department of Pulmonary, Allergy, and Critical Care Medicine at the Cleveland Clinic. "Predicting long-term prognosis in these patients usually requires analysis of several pieces of data in complicated risk scores. This easily measured, cost-free biomarker may ultimately advance patient care in view of its ability to accurately predict clinical worsening even in patients receiving treatment for pulmonary hypertension."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

The study enrolled 75 patients with a diagnosis of IPAH, confirmed by right heart catheterization. Heart rate was recorded at the end of the 6MW test and then one minute after completing the test. Clinical worsening was defined as any of the end points of death, lung transplantation, hospitalization for worsening PH, or escalation of PH therapy. The cutoff value for abnormal HRR at one minute following the 6MW test was identified as 16 beats. A greater reduction in heart rate after exercise indicates a better-conditioned heart.

"Patients with HRR1 <16 were significantly more likely to have clinical worsening events and also had significantly shorter time to clinical worsening (6.7 months versus 13 months) than those patients with HRR1≥16," according to Dr. Minai. "The odds of clinical worsening were significantly greater among patients with HRR1 <16 at all time points during follow-up."

HRR1<16 was a better predictor of clinical worsening than 6MWD alone, and when added to 6MWD improved the ability of 6MWD to predict time to clinical worsening. "HRR1<16 was also associated with known predictors of poor prognosis in IPAH," Dr. Minai added. "Patients with HRR1<16 were more likely to need supplemental oxygen during the 6MW test, be in World Health Organization functional class 4, and have more severe right ventricular dysfunction and pericardial effusion."

The study had some limitations, including its retrospective design. In addition, the time lag between right heart catheterization and the 6MW test may have biased the results, because treatment may have altered baseline hemodynamic parameters.

"HRR1 is highly predictive of clinical worsening and time to clinical worsening in patients with IPAH," concludes Dr. Minai, "and is highly correlated with known indicators of poor prognosis in these patients. Clinical worsening and time to clinical worsening have been used as end-points in a number of clinical trials in patients with IPAH. The strong predictive ability of HRR1 in these patients could make it a valuable new tool for measuring treatment response. Further study in larger prospective studies will better define its role in both IPAH and other forms of PAH."


Contact: Nathaniel Dunford
American Thoracic Society

Related biology news :

1. Study explains how heart attack can lead to heart rupture
2. Gladstone scientist receives American Heart Associations Katz prize for cardiovascular research
3. Scarring a necessary evil to prevent further damage after heart attack
4. Gladstone founder receives American Heart Association Distinguished Scientist Award
5. Post heart attack recovery may not be aided by stem cell injections, but trial demonstrates promise
6. Results triple researchers projections with use of adult stem cells for heart failure
7. Low vitamin C levels may raise heart failure patients risk
8. Diseased hearts to heal themselves in future
9. Biologists use flies and mice to get to the heart of Down syndrome
10. Targeting leg fatigue in heart failure
11. Fatty acids involved in python heart growth could benefit diseased human heart
Post Your Comments:
(Date:11/17/2015)... 2015 Paris from 17 ... Paris from 17 th until 19 ... innovation leader, has invented the first combined scanner in the ... same scanning surface. Until now two different scanners were required: one ... capture both on the same surface. This innovation is ...
(Date:11/17/2015)... 2015  Vigilant Solutions announces today that Mr. ... Directors. --> --> ... the partnership at TPG Capital, one of the largest ... Billion in revenue.  He founded and led TPG,s Operating ... companies, from 1997 to 2013.  In his first role, ...
(Date:11/16/2015)... 16, 2015  Synaptics Inc. (NASDAQ: SYNA ... today announced expansion of its TDDI product portfolio ... controller and display driver integration (TDDI) solutions designed ... new TDDI products add to the previously-announced ... (WQHD resolution), and TD4322 (FHD resolution) solutions. All ...
Breaking Biology News(10 mins):
(Date:11/30/2015)... 1, 2015 /PRNewswire/ - BioAmber Inc. (NYSE: BIOA ), a ... the American Business Act on Climate Pledge, alongside more than ... with the Obama Administration to demonstrate an ongoing commitment to ... to the COP21 Paris climate negotiations. ... Sarnia, Canada . --> BioAmber uses ...
(Date:11/30/2015)... ALBANY, N.Y. , Nov. 30, 2015 /PRNewswire-USNewswire/ ... led by assistant chemistry professor Jan Halámek, is ... level.   --> ...   --> ... researchers at UAlbany have discovered a straightforward concept ...
(Date:11/30/2015)... 30, 2015 /PRNewswire/ - Zenith Epigenetics Corp. ("Zenith" or the ... C.W. Wong to its Board of Directors to replace ... with a wealth of experience as co-founder of Resverlogix, with ... --> --> Dr. Wong remarked, ... of directors. Zenith,s long standing expertise in epigenetics and the ...
(Date:11/30/2015)... ... November 30, 2015 , ... ... exhibition Jurassic World: The Exhibition, opening in March 2016 at Melbourne Museum in ... worldwide tour including several North American tour dates. The Exhibition is based on ...
Breaking Biology Technology: