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Prognostic value of chronotropic incompetence in elderly patients undergoing exercise echocardiography

Juliana Silva Santana1, José Carlos Sizino Franco Filho, Antônio Arestides de Sá Neto

  • 1Universidade Federal de Sergipe1; Hospital e Clínica São Lucas2, Aracaju, SE - Brazil. julianasilvasantana@hotmail.com

Arquivos Brasileiros De Cardiologia
|May 10, 2013
PubMed

Insights

Chronotropic incompetence (CI) is linked to a higher risk of cerebrovascular disease in elderly diabetic patients. This heart condition may also predict worse outcomes when combined with acute myocardial infarction.

Area of Science:

  • Cardiology
  • Geriatrics
  • Diabetology

Background:

  • Chronotropic incompetence (CI) is defined as failing to reach 80% of the age-predicted heart rate.
  • CI is a known predictor of mortality and adverse cardiovascular events.
  • CI may indicate a poorer prognosis in elderly individuals with diabetes.

Purpose of the Study:

  • To assess the prognostic significance of CI in elderly diabetic patients.
  • To examine the association of CI with acute myocardial infarction (AMI), cerebrovascular disease (CVD), and overall mortality.
  • To compare clinical and echocardiographic features between CI and non-CI patients.

Main Methods:

  • A cohort of 298 elderly diabetic patients undergoing exercise echocardiography (EE) was analyzed.
  • Patients were divided into two groups: 109 with CI (group 1) and 179 without CI (group 2).
  • Data collected included cardiovascular events, clinical characteristics, and echocardiographic findings.

Main Results:

  • CI patients exhibited a significantly higher incidence of CVD (9.2% vs. 3.2%, p=0.027).
  • Higher mortality was observed in CI patients who experienced CVD or AMI.
  • Factors like typical angina, dyspnea before EE, male gender, and specific echocardiographic parameters were more prevalent in the CI group.

Conclusions:

  • Chronotropic incompetence is an independent risk factor for cerebrovascular disease in elderly diabetic individuals.
  • CI may serve as a prognostic marker in this patient population.
Abstract

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