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Chronotropic response during exercise testing in old people

D Zdrenghea1, L Gheorghiu, A Vultur

  • 1Division of Cardiology, Rehabilitation Hospital, Cluj-Napoca, Romania.

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|July 1, 1993
PubMed
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Older adults may show a depressed chronotropic response to exercise, indicating potential subclinical sinus node dysfunction. This early sign warrants further investigation in geriatric cardiovascular health.

Area of Science:

  • Cardiology
  • Geriatrics
  • Exercise Physiology

Background:

  • Sinus node dysfunction (SND) can affect heart rate regulation.
  • Assessing chronotropic response during exercise is crucial for cardiovascular health evaluation.
  • Aging is associated with potential changes in cardiac autonomic function.

Purpose of the Study:

  • To investigate the prevalence of depressed chronotropic response to exercise in older adults.
  • To determine if this response is an early indicator of subclinical sinus node dysfunction.
  • To compare exercise-induced heart rate changes between younger and older individuals.

Main Methods:

  • A maximal, symptom-limited exercise test (ET) was performed on 118 subjects over 60 years (Group A) and 25 subjects under 60 years (Group B) using a cycloergometer.

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  • Heart rate (HR) at rest and during exercise was monitored.
  • Chronotropic impairment (Chl) was calculated as the HR increment at each effort level.

    • Main Results:

    • No significant statistical differences in resting HR, HR increase per effort level, or mean Chl were observed between Group A and Group B.
    • Individually, a depressed chronotropic response (HR increment < 15 beats/min) was found in 22.3% of older adults (Group A) versus 4% in younger adults (Group B).
    • A significant depression (HR increment < 10 beats/min) was noted in 15% of Group A subjects, but none in Group B.

    Conclusions:

    • Approximately one-quarter of older adults exhibit a depressed chronotropic response to exercise.
    • This finding suggests a potential subclinical sinus node dysfunction in a significant portion of the elderly population.
    • The depressed chronotropic response to exercise may serve as an early marker for age-related cardiac autonomic changes.