Heart failure & cardiomyopathiesCohort study
What about chronotropic incompetence in heart failure with mildly reduced ejection fraction? Clinical and prognostic implications from the Metabolic Exercise combined with Cardiac and Kidney Indexes score dataset
- Retrospective cohort study
- multicentre
- MECKI database
Authors' conclusion
The study suggests an association between blunted exercise-HR response, functional capacity, and CV death risk among patients with HFmrEF.
Study context
- Population
- Stable outpatients with HF with mildly reduced EF who performed maximal cardiopulmonary exercise testing (CPET) at the cycle ergometer, without significant rhythm disorders or comorbiditiesof 1164 outpatients
- Participants
- 864 outpatients
- Exposure
- Chronotropic incompetence and cardiovascular (CV) death
- Outcome
- CV death
Main finding
As reported in the abstract
Hazard ratio (CI)P value
pHR%
0.97(0.95–0.99)
P < 0.05pHRR%
0.977(0.961–0.993)
P < 0.01- CV deaths
- 84 (9.7%)
- CV deaths within 5 years
- 39 (4.5%)
Observational data: associations, not effects.
Further findings
Prevalence of chronotropic incompetence (by method and cut-off)
- Prevalence range across methods (pHR% ≤75% to ≤60%; pHRR% ≤65% to ≤50%)
- 11% to 62%
Original publication
What about chronotropic incompetence in heart failure with mildly reduced ejection fraction? Clinical and prognostic implications from the Metabolic Exercise combined with Cardiac and Kidney Indexes score dataset. Eur J Prev Cardiol. Published 27 October 2023. doi:10.1093/eurjpc/zwad338
Summarised from the published abstract; every number is checked against it