Chronotropic incompetence and autonomic dysfunction in patients without structural heart disease
Open accessAbstract
AIMS: An attenuated heart rate response to exercise, termed chronotropic incompetence (CI), has been reported to be an independent predictor of cardiovascular mortality. We examined the change in autonomic function during exercise testing and correlated the results with CI. METHODS AND RESULTS: Exercise testing using a bicycle ergometer was performed in 172 patients who had no evidence of cardiac disease. Chronotropic incompetence was defined as the failure to achieve 85% of the age-predicted maximum heart rate, heart rate reserve <80%, or chronotropic response index <0.80. We analysed the relationship between CI and the change in two components of heart rate variability during exercise testing: high-frequency (HF) component (0.15-0.40 Hz) as an index of vagal modulation and the ratio of low-frequency (LF) component (0.04-0.15 Hz) to HF component as an index of sympathovagal balance. Heart rate variability indexes before exercise were similar in patients with and without CI. Percentage changes after exercise in the ratio of LF to HF component were higher in patients with CI than in those without CI (84 +/- 15 vs. 41 +/- 16%, P < 0.05), whereas percentage changes in an HF component were similar in the two groups. CONCLUSION: Our data suggested that CI in patients without structural heart disease was mainly caused by a pathophysiological condition in which sympathetic activation was not well translated into heart rate increase. Further study is needed to determine the post-synaptic sensitivity of the beta-adrenergic receptor pathway in relation to CI.
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- Authors
- Kawasaki, T., Kaimoto, S., Sakatani, T., Miki, S., Kamitani, T., Kuribayashi, T., Matsubara, H., & Sugihara, H.
- Affiliations
- Matsushita Memorial Hospital (JP)
- Kyoto Prefectural University (JP)
- Corresponding author
- Kawasaki, T.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-01-22
- Volume
- 12
- Issue
- 4
- Pages
- 561-566
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2009587500
- Cited by
- 47
- References
- 41
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- chronotropic incompetence, autonomic dysfunction, heart rate variability, exercise testing, vagal modulation, sympathovagal balance, beta-adrenergic receptor sensitivity, cardiovascular mortality, asymptomatic patients
- MeSH terms
- Aged, Autonomic Nervous System Diseases, Blood Pressure, Exercise Test, Female, Heart, Heart Rate, Humans, Male, Middle Aged, Vagus Nerve
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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