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Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
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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, Cl was an independent and powerful outcome predictor in patients with severe COPD. (C) 2013 Elsevier B.V. All rights reserved.
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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. _Respiratory Physiology & Neurobiology_. 2013. Vol. 188, núm. 2, pàgs. 113-118. [consulta: 26 de febrer de 2026]. [Disponible a: https://hdl.handle.net/2445/126452]