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Defining the optimum upper heart rate limit during exercise: a study in pacemaker patients with heart failure
M Kindermann1, B Schwaab, N Finkler
1Department of Internal Medicine, Universitätskliniken des Saarlandes, Homburg/Saar, Germany.
European Heart Journal
|August 15, 2002
Summary
Determining the optimal maximum heart rate is crucial for heart failure patients. Cardiopulmonary exercise testing and exercise Doppler echocardiography effectively identify this limit, preventing excessive heart rates.
Area of Science:
- Cardiology
- Exercise Physiology
- Diagnostic Imaging
Background:
- Optimal maximum exercise heart rate determination lacks a non-invasive method.
- Crucial for managing tachycardia intolerance in structural heart disease patients.
Purpose of the Study:
- Define optimal maximum heart rate using cardiopulmonary exercise testing (CPET) and exercise Doppler echocardiography (EDE).
- Compare CPET and EDE for determining the optimal upper heart rate limit.
Main Methods:
- Evaluated 49 pacemaker patients with chronotropic incompetence.
- Determined optimal upper rate limit via CPET and EDE.
- Identified limits based on oxygen consumption and myocardial performance index.
Main Results:
- In patients with normal ejection fraction (>or=55%), the limit was 86% of age-predicted maximum heart rate.
- In patients with left ventricular dysfunction (ejection fraction
- CPET and EDE showed strong correlation (P<0.0001) with a mean deviation of 6+/-6 bpm.
Conclusions:
- CPET and EDE are valuable for determining the optimal upper heart rate limit in heart failure patients.
- These methods help avoid excessive heart rates and are applicable beyond pacemaker patients.
- Useful for guiding therapeutic interventions with chronotropic drugs.