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Chronotropic incompetency

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https://www.readbyqxmd.com/read/29068357/chronotropic-competence-indices-extracted-from-wearable-sensors-for-cardiovascular-diseases-management
#1
Jiankang Wu, Jianan Li, Andrew Seely, Yi Zhu, Sisi Huang, Xiaoqin Wang, Lei Zhao, Hongliang Wang, Herry Christophe
Chronotropic incompetence (CI) has been proven to be an important factor in the diagnosis and management of cardiovascular diseases. In this paper, we extend the existing CI parameters and propose chronotropic competence indices (CCI) to describe the exercise response of the cardiopulmonary system. A cardiac chronotropic competence Test (3CT), dedicated to CCI measurement using a wearable device, is also presented. Preliminary clinical trials are presented for the validation of 3CT measurement accuracy, and to show the potential of CCI in the prevention and rehabilitation of cardiovascular diseases...
October 25, 2017: Sensors
https://www.readbyqxmd.com/read/28966043/less-is-more-can-we-achieve-cardiac-resynchronization-with-2-leads-only
#2
Mauro Biffi, Giulia Massaro, Andrea Candelora, Andrea Angeletti, Cinzia Valzania, Cristian Martignani, Diego Grassini, Igor Diemberger, Matteo Ziacchi
BACKGROUND: We compared clinical and technical outcome of CRT recipients treated either with a conventional 3‑leads (3L) CRTD or with the new 2‑leads (DX) CRTD that enables atrial signal detection by a floating dipole built on a pentafilar RV lead. METHODS: Echocardiography and cardiopulmonary exercise tests were repeated either before CRTD implantation and between 6 and 12 months follow up in consecutively implanted patients who had a resting heart rate>40bpm at maximum tolerated beta-blocker dosage...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28895507/functional-impact-of-exercise-pulmonary-hypertension-in-patients-with-borderline-resting-pulmonary-arterial-pressure
#3
Rudolf K F Oliveira, Mariana Faria-Urbina, Bradley A Maron, Mario Santos, Aaron B Waxman, David M Systrom
Borderline resting mean pulmonary arterial pressure (mPAP) is associated with adverse outcomes and affects the exercise pulmonary vascular response. However, the pathophysiological mechanisms underlying exertional intolerance in borderline mPAP remain incompletely characterized. In the current study, we sought to evaluate the prevalence and functional impact of exercise pulmonary hypertension (ePH) across a spectrum of resting mPAP's in consecutive patients with contemporary resting right heart catheterization (RHC) and invasive cardiopulmonary exercise testing...
July 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28845312/symptomatic-long-pauses-and-bradycardia-due-to-massive-multinodular-goiter
#4
Amrish Deshmukh, Cevher Ozcan
Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28695974/what-determine-the-quality-of-life-of-adult-patients-after-fontan-procedure
#5
Monika Smaś-Suska, Natalia Dłużniewska, Piotr Weryński, Jacek Pająk, Wojciech Płazak, Maria Olszowska, Piotr Podolec, Lidia Tomkiewicz-Pająk
BACKGROUND: Despite the low early mortality of Fontan procedures, Fontan patients are prone to various cardiac and extra-cardiac complications in the long term. This may influence patient perception of their health and outcome. The aim of the study was to assess the relationship of multi-organ complications and physical efficiency with self-reported health-related quality of life (QOL) in adult Fontan patients. METHODS: Quality of life was assessed with the Short Form-36 questionnaire...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28592193/permanent-chronotropic-impairment-after-closure-of-atrial-or-ventricular-septal-defect
#6
REVIEW
Johan Heiberg, Camilla Nyboe, Vibeke E Hjortdal
OBJECTIVES: Atrial and ventricular septal defects are commonly closed surgically with low rates of post-operative morbidity, and the long-term outcome has widely been described as benign. Nevertheless, there is an increasing understanding of late morbidity, and the possibility of postoperative chronotropic impairment is continuously questioned. Furthermore, potentially abnormal chronotropic responses may be associated with the recently demonstrated overrepresentation of late arrhythmias...
October 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28545575/impaired-chronotropic-response-to-physical-activities-in-heart-failure-patients
#7
Hong Shen, Jianrong Zhao, Xiaohong Zhou, Jingbo Li, Qing Wan, Jing Huang, Hui Li, Liqun Wu, Shungang Yang, Ping Wang
BACKGROUND: While exercise-based cardiac rehabilitation has a beneficial effect on heart failure hospitalization and mortality, it is limited by the presence of chronotropic incompetence (CI) in some patients. This study explored the feasibility of using wearable devices to assess impaired chronotropic response in heart failure patients. METHODS: Forty patients with heart failure (left ventricular ejection fraction, LVEF: 44.6 ± 5.8; age: 54.4 ± 11.7) received ECG Holter and accelerometer to monitor heart rate (HR) and physical activities during symptom-limited treadmill exercise testing, 6-min hall walk (6MHW), and 24-h daily living...
May 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28543947/%C3%AE-1-adrenoceptor-but-not-%C3%AE-2-adrenoceptor-subtype-regulates-heart-rate-in-type-2-diabetic-rats-in-vivo
#8
Rosalind F Cook, Carol T Bussey, Kimberley M Mellor, Patricia A Cragg, Regis R Lamberts
What is the central question of the study? The sympathetic system regulates heart rate via β-adrenoceptors; this is impaired during diabetes. However, the specific β-adrenoceptor subtype contributions in heart rate regulation in diabetes in vivo are unknown. What is the main finding and its importance? Telemetric recordings in conscious non-diabetic and type 2 diabetic rats demonstrated that the β1 -adrenoceptor subtype, and not the β2 -adrenoceptor, regulated the lower resting heart rate and increased β-adrenoceptor responsiveness in diabetes in vivo...
May 22, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28492564/-heart-rate-as-a-therapeutic-target-after-acute-coronary-syndrome-and-in-chronic-coronary-heart-disease
#9
Marco Ambrosetti, Giuseppe Scardina, Giuseppe Favretto, Pier Luigi Temporelli, Pompilio Massimo Faggiano, Cesare Greco, Roberto Franco Pedretti
For patients with stable coronary artery disease (SCAD), either after hospitalization for acute cardiac events or in the chronic phase, comprehensive treatment programs should be devoted to: (i) reducing mortality and major adverse cardiovascular events, (ii) reducing the ischemic burden and related symptoms, and (iii) increasing exercise capacity and quality of life.Heart rate (HR) has demonstrated to have prognostic value and patients beyond the limit of 70 bpm display increased risk of all the above adverse outcomes, even after adjustment for parameters such as the extension of myocardial infarction and the presence of heart failure...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28465117/a-novel-splice-site-hcn4-gene-mutation-c-1737-1-g-t-causes-familial-bradycardia-reduced-heart-rate-response-impaired-chronotropic-competence-and-increased-short-term-heart-rate-variability
#10
Lidia Hategan, Beáta Csányi, Balázs Ördög, Kornél Kákonyi, Annamária Tringer, Orsolya Kiss, Andrea Orosz, László Sághy, István Nagy, Zoltán Hegedűs, László Rudas, Márta Széll, András Varró, Tamás Forster, Róbert Sepp
BACKGROUND: The most important molecular determinant of heart rate regulation in sino-atrial pacemaker cells includes hyperpolarization-activated, cyclic nucleotide-gated ion channels, the major isoform of which is encoded by the HCN4 gene. Mutations affecting the HCN4 gene are associated primarily with sick sinus syndrome. METHODS AND RESULTS: A novel c.1737+1 G>T 'splice-site' HCN4 mutation was identified in a large family with familial bradycardia which co-segregated with the disease providing a two-point LOD score of 4...
April 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28460334/maximal-exhaustive-treadmill-test-features-in-patients-with-temporal-lobe-epilepsy-search-for-sudden-unexpected-death-biomarkers
#11
Guilherme L Fialho, Arthur G Pagani, Roger Walz, Peter Wolf, Katia Lin
Autonomic dysfunction may account for sudden unexpected death in patients with epilepsy (PWE). On the other hand, low cardiovascular fitness, which may affect autonomic function, is a risk factor for sudden death and all-cause mortality in the general population. Little is known about autonomic variables and cardiovascular response to exercise in PWE. We submitted thirty consecutive PWE with no known cardiovascular diseases to maximal treadmill test, comparing them with matched controls. All individuals were submitted to clinical assessment, 12-lead electrocardiogram (ECG) and echocardiogram to exclude cardiovascular disease...
April 24, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28451646/chronotropic-incompetence-and-risk-of-atrial-fibrillation-the-henry-ford-exercise-testing-fit-project
#12
Wesley T O'Neal, Waqas T Qureshi, Michael J Blaha, Zeina A Dardari, Jonathan K Ehrman, Clinton A Brawner, Elsayed Z Soliman, Mouaz H Al-Mallah
OBJECTIVES: To examine the association between chronotropic incompetence and incident atrial fibrillation (AF). BACKGROUND: Patients with inadequate heart rate response during exercise may have abnormalities in sinus node function or autonomic tone that predispose to the development of AF. METHODS: We examined the association between heart rate response and incident AF in 57,402 (mean age=54±13 years, 47% female, 64% white) patients free of baseline AF who underwent exercise-treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project...
November 2016: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28419703/exercise-capacity-following-pediatric-heart-transplantation-a-systematic-review
#13
Sara Peterson, Jennifer A Su, Jacqueline R Szmuszkovicz, Robert Johnson, Barbara Sargent
Pediatric HTs account for 13% of all HTs with >60% of recipients surviving at least 10 years post-HT. The purpose of this systematic review is to synthesize the literature on exercise capacity of pediatric HT recipients to improve understanding of the mechanisms that may explain the decreased exercise capacity. Six databases were searched for studies that compared the exercise capacity of HT recipients ≤21 years old with a control group or normative data. Sixteen studies were included. Pediatric HT recipients, as compared to controls or normative data, exhibit significantly higher resting HR, and at peak exercise exhibit significantly decreased HR, VO2 , power, work, minute ventilation, and exercise duration...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28375677/cardiopulmonary-exercise-testing-in-adult-congenital-heart-disease
#14
Valentina Mantegazza, Anna Apostolo, Alfred Hager
Recently, the number of patients with congenital heart diseases reaching adulthood has been progressively increasing in developed countries, and new issues are emerging: the evaluation of their capacity to cope with physical activity and whether this knowledge can be used to optimize medical management. A symptom-limited cardiopulmonary exercise test has proven to be an essential tool, because it can objectively evaluate the functional cardiovascular capacity of these patients, identify the pathological mechanisms of the defect (circulatory failure, shunts, and/or pulmonary hypertension), and help prescribe an individualized rehabilitation program when needed...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28290801/-comparison-of-verapamil-and-amlodipine-for-treatment-of-chronic-heart-failure-with-preserved-left-ventricular-ejection-fraction-in-patients-with-hypertensive-disease
#15
S G Kanorskii, A F Sereda
OBJECTIVE: to compare efficacy of verapamil and amlodipine in treatment of chronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction (EF) in patients with hypertensive disease (HD). MATERIAL AND METHODS: Patients with stage III HD, class II-III CHF, and LVEF more or equal 50% (n=167, age 48-70 years) underwent complex examination before and after 12 months of treatment with perindopril combined either with verapamil SR (n=85) or amlodipine (n=82)...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28286762/the-correlation-of-decreased-heart-rate-recovery-and-chronotropic-incompetence-with-exercise-capacity-in-idiopathic-pulmonary-arterial-hypertension-patients
#16
Changwei Wu, Jian Guo, Hui Liu, Bigyan Pudasaini, Wenlan Yang, Qinhua Zhao, Lan Wang, Jinming Liu
We show by this study that a decrease in HRR1 in IPAH patients is associated with severe limitation of exercise capacity. HRR1 < 16 beats and CI just after completion of a CPET could be an indicator of poor prognosis.
2017: BioMed Research International
https://www.readbyqxmd.com/read/28262206/chronotropic-incompetence-and-its-relation-to-exercise-intolerance-in-chronic-obstructive-pulmonary-disease
#17
Hai-Jian Liu, Jian Guo, Qin-Hua Zhao, Lan Wang, Wen-Lan Yang, Jing He, Su-Gang Gong, Jin-Ming Liu
BACKGROUND: To study the relationship between chronotropic incompetence (CI) and disease severity and to assess the effect of CI on exercise capacity in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Arterial blood gas analysis, pulmonary function test and cardiopulmonary exercise testing were conducted in 60 patients with stable COPD and 45 healthy volunteers. CI was defined using the chronotropic response index (CRI = (peak heart rate-resting heart rate) / (220-age-resting heart rate)...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28115291/reevaluating-modality-of-cardiopulmonary-exercise-testing-in-patients-with-heart-failure-and-resynchronization-therapy-relevance-of-heart-rate-adaptive-pacing
#18
Livia Goldraich, Heather J Ross, Farid Foroutan, Michael Walker, Juarez Braga, Michael A McDonald
BACKGROUND: Chronotropic incompetence (CI) in heart failure (HF) patients with cardiac resynchronization therapy (CRT) and activity sensors may vary according to exercise modality. We hypothesized that chronotropic response and exercise capacity differ when HF patients with CRT and heart rate (HR) adaptive pacing are exercised on cycloergometer versus treadmill. METHODS AND RESULTS: This is a crossover study in which stable HF patients with CRT and HR-adaptive pacing triggered by activity sensors underwent maximal symptom-limited cardiopulmonary exercise testing on both a cycloergometer and treadmill...
May 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27913834/key-role-of-pacing-site-as-determinant-factor-of-exercise-testing-performance-in-pediatric-patients-with-chronic-ventricular-pacing
#19
Michel Cabrera Ortega, Hiram Tápanes Duamy, Dunia B Benítez Ramos
Chronic right ventricular (RV) apical pacing has been associated with deterioration of functional capacity and chronotropic incompetence during exercise testing in children. The effects of alternative pacing site on exercise performance in pediatric population remain unknown. We evaluated the influence of ventricular pacing site on exercise capacity in pediatric patients with complete congenital atrioventricular block requiring permanent pacemaker therapy. Sixty-four children paced from RV apex (n = 26), RV midseptum (n = 15) and left ventricular (LV) apex (n = 23) were studied cross-sectionally...
February 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27887692/mechanisms-of-effort-intolerance-in-patients-with-heart-failure-and-borderline-ejection-fraction
#20
Yan Topilsky, Zach Rozenbaum, Shafik Khoury, Gregg S Pressman, Yaniv Gura, Jack Sherez, Avi Man, Jason Shimiaie, Sanford Edwards, Joshua Berookhim, Thierry Le Tourneau, Amir Halkin, Simon Biner, Gad Keren, Galit Aviram
Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A-VO2 difference). We evaluated mechanisms of effort intolerance in patients with heart failure with borderline (40% to 49%) left ventricular ejection fraction (EF) (HF and Borderline Ejection fraction). We included 89 consecutive patients with HF and Borderline Ejection fraction (n = 25; 63.6 ± 14 years, 64% men), control subjects (n = 22), patients with HF with preserved EF (n = 26; EF ≥50%), and patients with HF with reduced EF (n = 16; <40%)...
February 1, 2017: American Journal of Cardiology
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