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Updated: Aug 14, 2026

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
Early heart rate recovery after exercise predicts mortality in patients with chronic heart failure
Serafim Nanas1, Maria Anastasiou-Nana, Stavros Dimopoulos
1Pulmonary and Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, National and Kapodestrian University of Athens, 20, Papadiamantopoulou str, Athens, 11528, Greece. snanas@cc.uoa.gr
Background:
Patients with chronic heart failure (CHF) have multiple abnormalities of autonomic regulation that have been associated to their high mortality rate. Heart rate recovery immediately after exercise is an index of parasympathetic activity, but its prognostic role in CHF patients has not been determined yet.
Methods:
Ninety-two stable CHF patients (83M/9F, mean age: 51+/-12 years) performed an incremental symptom-limited cardiopulmonary exercise testing. Measurements included peak O2 uptake (VO2p), ventilatory response to exercise (VE/VCO2 slope), the first-degree slope of VO2 for the 1st minute of recovery (VO2/t-slope), heart rate recovery [(HRR1, bpm): HR difference from peak to 1 min after exercise] and chronotropic response to exercise [%chronotropic reserve (CR, %)=(peak HR-resting HR/220-age-resting HR)x100]. Left ventricular ejection fraction (LVEF, %) was also measured by radionuclide ventriculography.
Results:
Fatal events occurred in 24 patients (26%) during 21+/-6 months of follow-up. HRR1 was lower in non-survivors (11.4+/-6.4 vs. 20.4+/-8.1; p<0.001). All cause-mortality rate was 65% in patients with HRR1
Conclusions:
Early heart rate recovery is an independent prognostic risk indicator in CHF patients and could be used in CHF risk stratification.
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