Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure
Abstract Aims Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysing the open HOMAGE (Heart OMics in Aging)...
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Wiley
2024-12-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15000 |
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| author | Fang‐Fei Wei Beatrice Mariottoni De‐Wei An Pierpaolo Pellicori Yu‐Ling Yu Job A. J. Verdonschot Chen Liu Fozia Z. Ahmed Johannes Petutschnigg Patrick Rossignol Stephane Heymans Joe Cuthbert Nicolas Girerd Yan Li Andrew L. Clark Tim S. Nawrot João Pedro Ferreira Faiez Zannad John G. F. Cleland Jan A. Staessen the HOMAGE investigators |
| author_facet | Fang‐Fei Wei Beatrice Mariottoni De‐Wei An Pierpaolo Pellicori Yu‐Ling Yu Job A. J. Verdonschot Chen Liu Fozia Z. Ahmed Johannes Petutschnigg Patrick Rossignol Stephane Heymans Joe Cuthbert Nicolas Girerd Yan Li Andrew L. Clark Tim S. Nawrot João Pedro Ferreira Faiez Zannad John G. F. Cleland Jan A. Staessen the HOMAGE investigators |
| author_sort | Fang‐Fei Wei |
| collection | DOAJ |
| description | Abstract Aims Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysing the open HOMAGE (Heart OMics in Aging) trial. Methods In HOMAGE, 527 patients prone to heart failure were randomized to usual treatment with or without spironolactone (25–50 mg/day). The current sub‐study included 113 controls and 114 patients assigned spironolactone (~70% on beta‐blockers), who all completed the ISWT at baseline and at Months 1 and 9. Within‐group changes over time (follow‐up minus baseline) and between‐group differences at each time point (spironolactone minus control) were analysed by repeated measures ANOVA, unadjusted or adjusted for sex, age and body mass index, and additionally for baseline for testing 1 and 9 month data. Results Irrespective of randomization, the resting HR and CHR did not change from baseline to follow‐up, with the exception of a small decrease in the HR immediately post‐exercise (−3.11 b.p.m.) in controls at Month 9. In within‐group analyses, HR decline over the 5 min post‐exercise followed a slightly lower course at the 1 month visit in controls and at the 9 month visits in both groups, but not at the 1 month visit in the spironolactone group. Compared with baseline, EE increased by two to three shuttles at Months 1 and 9 in the spironolactone group but remained unchanged in the control group. In the between‐group analyses, irrespective of adjustment, there were no HR differences at any time point from rest up to 5 min post‐exercise or in EE. Subgroup analyses by sex or categorized by the medians of age, left ventricular ejection fraction or glomerular filtration rate were confirmatory. Combining baseline and Months 1 and 9 data in both treatment groups, the resting HR, CHR and HRR at 1 and 5 min averaged 61.5, 20.0, 9.07 and 13.8 b.p.m. and EE 48.3 shuttles. Conclusions Spironolactone on top of usual treatment compared with usual treatment alone did not change resting HR, CHR, HRR and EE in response to ISWT. Beta‐blockade might have concealed the effects of spironolactone. The current findings demonstrate that the ISWT, already used in a wide variety of pathological conditions, is a practical instrument to measure symptom‐limited exercise capacity in patients prone to developing heart failure because of coronary heart disease. |
| format | Article |
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| issn | 2055-5822 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
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| series | ESC Heart Failure |
| spelling | doaj-art-43a2b4bb7a694846b392ef02df411b552025-08-20T01:54:57ZengWileyESC Heart Failure2055-58222024-12-011164116412610.1002/ehf2.15000Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failureFang‐Fei Wei0Beatrice Mariottoni1De‐Wei An2Pierpaolo Pellicori3Yu‐Ling Yu4Job A. J. Verdonschot5Chen Liu6Fozia Z. Ahmed7Johannes Petutschnigg8Patrick Rossignol9Stephane Heymans10Joe Cuthbert11Nicolas Girerd12Yan Li13Andrew L. Clark14Tim S. Nawrot15João Pedro Ferreira16Faiez Zannad17John G. F. Cleland18Jan A. Staessen19the HOMAGE investigatorsDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaDepartment of Cardiology Cortona Hospital Arezzo ItalyNon‐Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED) Mechelen BelgiumBritish Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health University of Glasgow Glasgow UKNon‐Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED) Mechelen BelgiumDepartment of Cardiology Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou ChinaDivision of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre University of Manchester Manchester UKDepartment of Internal Medicine and Cardiology Campus Virchow Klinikum, Charité University Medicine Berlin, Berlin Institute of Health and German Center for Cardiovascular Research, Partner Site Berlin Berlin GermanyUniversité de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F‐CRIN INI‐CRCT Nancy FranceDepartment of Cardiology Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology Castle Hill Hospital, University of Hull Cottingham UKUniversité de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F‐CRIN INI‐CRCT Nancy FranceDepartment of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Cardiology Castle Hill Hospital, University of Hull Cottingham UKResearch Unit Environment and Health, KU Leuven Department of Public Health and Primary Care University of Leuven Leuven BelgiumDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine University of Porto Porto PortugalUniversité de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F‐CRIN INI‐CRCT Nancy FranceBritish Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health University of Glasgow Glasgow UKNon‐Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED) Mechelen BelgiumAbstract Aims Few randomized trials assessed the changes over time in the chronotropic heart rate (HR) reactivity (CHR), HR recovery (HRR) and exercise endurance (EE) in response to the incremental shuttle walk test (ISWT). We addressed this issue by analysing the open HOMAGE (Heart OMics in Aging) trial. Methods In HOMAGE, 527 patients prone to heart failure were randomized to usual treatment with or without spironolactone (25–50 mg/day). The current sub‐study included 113 controls and 114 patients assigned spironolactone (~70% on beta‐blockers), who all completed the ISWT at baseline and at Months 1 and 9. Within‐group changes over time (follow‐up minus baseline) and between‐group differences at each time point (spironolactone minus control) were analysed by repeated measures ANOVA, unadjusted or adjusted for sex, age and body mass index, and additionally for baseline for testing 1 and 9 month data. Results Irrespective of randomization, the resting HR and CHR did not change from baseline to follow‐up, with the exception of a small decrease in the HR immediately post‐exercise (−3.11 b.p.m.) in controls at Month 9. In within‐group analyses, HR decline over the 5 min post‐exercise followed a slightly lower course at the 1 month visit in controls and at the 9 month visits in both groups, but not at the 1 month visit in the spironolactone group. Compared with baseline, EE increased by two to three shuttles at Months 1 and 9 in the spironolactone group but remained unchanged in the control group. In the between‐group analyses, irrespective of adjustment, there were no HR differences at any time point from rest up to 5 min post‐exercise or in EE. Subgroup analyses by sex or categorized by the medians of age, left ventricular ejection fraction or glomerular filtration rate were confirmatory. Combining baseline and Months 1 and 9 data in both treatment groups, the resting HR, CHR and HRR at 1 and 5 min averaged 61.5, 20.0, 9.07 and 13.8 b.p.m. and EE 48.3 shuttles. Conclusions Spironolactone on top of usual treatment compared with usual treatment alone did not change resting HR, CHR, HRR and EE in response to ISWT. Beta‐blockade might have concealed the effects of spironolactone. The current findings demonstrate that the ISWT, already used in a wide variety of pathological conditions, is a practical instrument to measure symptom‐limited exercise capacity in patients prone to developing heart failure because of coronary heart disease.https://doi.org/10.1002/ehf2.15000heart failureheart rateincremental shuttle walk testmineralocorticoid receptor antagonismspironolactone |
| spellingShingle | Fang‐Fei Wei Beatrice Mariottoni De‐Wei An Pierpaolo Pellicori Yu‐Ling Yu Job A. J. Verdonschot Chen Liu Fozia Z. Ahmed Johannes Petutschnigg Patrick Rossignol Stephane Heymans Joe Cuthbert Nicolas Girerd Yan Li Andrew L. Clark Tim S. Nawrot João Pedro Ferreira Faiez Zannad John G. F. Cleland Jan A. Staessen the HOMAGE investigators Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure ESC Heart Failure heart failure heart rate incremental shuttle walk test mineralocorticoid receptor antagonism spironolactone |
| title | Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure |
| title_full | Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure |
| title_fullStr | Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure |
| title_full_unstemmed | Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure |
| title_short | Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure |
| title_sort | heart rate reactivity recovery and endurance of the incremental shuttle walk test in patients prone to heart failure |
| topic | heart failure heart rate incremental shuttle walk test mineralocorticoid receptor antagonism spironolactone |
| url | https://doi.org/10.1002/ehf2.15000 |
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