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Chronotropic incompetence and coronary artery disease

Fernando Diego Anjos-Andrade1, Antônio Carlos Sobral Sousa, José Augusto Soares Barreto-Filho

  • 1Department of Internal Medicine, Cardiology Division of Federal University of Sergipe, Sergipe, Brazil.

Acta Cardiologica
|February 10, 2011
PubMed

Insights

Chronotropic incompetence (CI) is linked to impaired left ventricular function during peak exercise. This condition is also associated with critical lesions in the right coronary artery, highlighting potential mechanisms for CI.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Diagnostic Imaging

Background:

  • Chronotropic incompetence (CI) is an independent predictor of mortality and coronary artery disease incidence.
  • The underlying pathophysiological mechanisms of CI are not fully understood.

Purpose of the Study:

  • To investigate the association between CI and left ventricular (LV) wall motion abnormalities.
  • To evaluate the relationship between CI and the location of coronary arterial lesions.

Main Methods:

  • Exercise echocardiography was performed on 610 patients with ischemia.
  • Patients were categorized into two groups based on heart rate (HR) response during treadmill testing: ChI (did not reach 85% of max HR) and ChC (achieved 85% of max HR).
  • Wall motion abnormalities were assessed using the wall motion score index (WMSI).

Main Results:

  • The ChI group exhibited higher frequencies of dyspnea, systemic hypertension, and obesity, along with lower exercise tolerance compared to the ChC group.
  • The WMSI was significantly higher in the ChI group at both rest and peak exercise, indicating impaired LV systolic function.
  • Severe right coronary artery lesions were independently associated with CI (adjusted OR = 3.57).

Conclusions:

  • Chronotropic incompetence is associated with impaired ventricular function during peak exercise.
  • Critical lesions in the right coronary artery are linked to the presence of chronotropic incompetence.
Abstract

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