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Heart Rate and Oxygen Saturation Change Patterns During 6-min Walk Test in Subjects With Chronic Thromboembolic

Takeshi Inagaki^1,2, Jiro Terada³, Misuzu Yahaba¹

¹Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Respiratory Care

|December 28, 2017

Abstract

Background:

The 6-min walk test (6MWT) is commonly performed to assess functional status in patients with chronic thromboembolic pulmonary hypertension. However, changes in heart rate and oxygen saturation (S_pO ) patterns during 6MWT in patients with chronic thromboembolic pulmonary hypertension remain unclear.

Methods:

Thirty-one subjects with chronic thromboembolic pulmonary hypertension were retrospectively evaluated to examine the relationships between the change in heart rate (Δheart rate), heart rate acceleration time, slope of heart rate acceleration, heart rate recovery during the first minute after 6MWT (HRR1), change in S_pO (ΔS_pO ), S_pO reduction time, and S_pO recovery time during 6MWT, and the severity of pulmonary hemodynamics assessed by right heart catheterization and echocardiography.

Results:

Subjects with severe chronic thromboembolic pulmonary hypertension had significantly longer heart rate acceleration time (144.9 ± 63.9 s vs 96.0 ± 42.5 s, P = .033), lower Δheart rate (47.4 ± 16.9 vs 61.8 ± 13.6 beats, P = .02), and lower HRR1 (13.3 ± 9.0 beats vs 27.1 ± 9.2 beats, P < .001) compared to subjects with mild chronic thromboembolic pulmonary hypertension. Subjects with severe chronic thromboembolic pulmonary hypertension also had significantly longer S_pO reduction time (178.3 ± 70.3 s vs 134.3 ± 58.4 s, P = .03) and S_pO recovery time (107.6 ± 35.3 s vs 69.8 ± 32.7 s, P = .004) than did subjects with mild chronic thromboembolic pulmonary hypertension. Multivariate linear regression analysis showed only mean pulmonary arterial pressure independently was associated with heart rate acceleration time and slope of heart rate acceleration.

Conclusions:

Heart rate and S_pO change patterns during 6MWT are predominantly associated with pulmonary hemodynamics in subjects with chronic thromboembolic pulmonary hypertension. Evaluating heart rate and S_pO change patterns during 6MWT may serve as a safe and convenient way to follow the change in pulmonary hemodynamics.

Keywords:

chronic thromboembolic pulmonary hypertension disease severity heart rate oxygen saturation pulmonary hemodynamics six-minute walk test

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