Highlights
- •Abnormal heart rate responses to exercise are common in COPD.
- •Heart rate responses are one measure of autonomic function.
- •Autonomic dysfunction may be a risk factor for acute respiratory events.
- •Better heart rate responses were associated with lower rates of respiratory events.
Abstract
Background
Lower heart rate (HR) increases during exercise and slower HR recovery (HRR) after
exercise are markers of worse autonomic function that may be associated with risk
of acute respiratory events (ARE).
Methods
Data from 6-min walk testing (6MWT) in COPDGene were used to calculate the chronotropic
index (CI) [(HR immediately post 6MWT – resting HR)/((220 – age) – resting HR)] and
HRR at 1 min after 6MWT completion. We used zero-inflated negative binomial regression
to test associations of CI and HRR with rates of any ARE (requiring steroids and/or
antibiotics) and severe ARE (requiring emergency department visit or hospitalization),
among all participants and in spirometry subgroups (normal, chronic obstructive pulmonary
disease [COPD], and preserved ratio with impaired spirometry).
Results
Among 4,484 participants, mean follow-up time was 4.1 years, and 1,966 had COPD. Among
all participants, CI-6MWT was not associated with rate of any ARE [adjusted incidence
rate ratio (aIRR) 0.98 (0.95–1.01)], but higher CI-6MWT was associated with lower
rate of severe ARE [0.95 (0.92–0.99)]. Higher HRR was associated with a lower rate
of both any ARE [0.97 (0.95–0.99)] and severe ARE [0.95 (0.92–0.98)]. Results were
similar in the COPD spirometry subgroup.
Conclusion
Heart rate measures derived from 6MWT tests may have utility in predicting risk of
acute respiratory events and COPD exacerbations.
Keywords
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Article info
Publication history
Published online: February 17, 2022
Accepted:
February 13,
2022
Received in revised form:
February 4,
2022
Received:
November 2,
2021
Identification
Copyright
Published by Elsevier Ltd.
