TY - JOUR
T1 - Predicting maximal HR in heart failure patients on β-blockade therapy
AU - Keteyian, Steven J.
AU - Kitzman, Dalane
AU - Zannad, Faiez
AU - Landzberg, Joel
AU - Arnold, J. Malcolm
AU - Brubaker, Peter
AU - Brawner, Clinton A.
AU - Bensimhon, Daniel
AU - Hellkamp, Anne S.
AU - Ewald, Greg
PY - 2012/3
Y1 - 2012/3
N2 - PURPOSE: Standards for estimating maximal HR are important when interpreting the adequacy of physiologic stress during exercise testing, assessing chronotropic response, and prescribing an exercise training regimen. The equation 220 - age is used to estimate maximum HR; however, it overestimates measured maximal HR in patients taking β-adrenergic blockade (βB) therapy. This study developed and validated a practical equation to predict maximal HR in patients with heart failure (HF) taking βB therapy. METHODS: Data from symptom-limited exercise tests completed on patients with systolic HF participating in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training trial and taking a βB agent were used to develop a simplified equation, which was validated using bootstrapping. RESULTS: The simplified derived equation was 119 + 0.5 (resting HR) - 0.5 (age) - (0, if test was completed using a treadmill; 5, if using a stationary bike). The R 2 and SEE were 0.28 and 18 beats•min, respectively. Validation of this equation yielded a mean R 2 and SEE of 0.28 and 18 beats•min, respectively. For the equation 220 - age, the R 2 was -2.93, and the SEE was 43 beats•min. CONCLUSIONS: We report a valid and simple population-specific equation for estimating peak HR in patients with HF taking βB therapy. This equation should be helpful when evaluating chronotropic response or assessing if a maximum effort was provided during exercise testing. We caution, however, that the magnitude of the variation (SEE = 18 beats•min -1) associated with this prediction equation may make it impractical when prescribing exercise intensity.
AB - PURPOSE: Standards for estimating maximal HR are important when interpreting the adequacy of physiologic stress during exercise testing, assessing chronotropic response, and prescribing an exercise training regimen. The equation 220 - age is used to estimate maximum HR; however, it overestimates measured maximal HR in patients taking β-adrenergic blockade (βB) therapy. This study developed and validated a practical equation to predict maximal HR in patients with heart failure (HF) taking βB therapy. METHODS: Data from symptom-limited exercise tests completed on patients with systolic HF participating in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training trial and taking a βB agent were used to develop a simplified equation, which was validated using bootstrapping. RESULTS: The simplified derived equation was 119 + 0.5 (resting HR) - 0.5 (age) - (0, if test was completed using a treadmill; 5, if using a stationary bike). The R 2 and SEE were 0.28 and 18 beats•min, respectively. Validation of this equation yielded a mean R 2 and SEE of 0.28 and 18 beats•min, respectively. For the equation 220 - age, the R 2 was -2.93, and the SEE was 43 beats•min. CONCLUSIONS: We report a valid and simple population-specific equation for estimating peak HR in patients with HF taking βB therapy. This equation should be helpful when evaluating chronotropic response or assessing if a maximum effort was provided during exercise testing. We caution, however, that the magnitude of the variation (SEE = 18 beats•min -1) associated with this prediction equation may make it impractical when prescribing exercise intensity.
KW - CHRONOTROPIC INCOMPETENCE
KW - EXERCISE
KW - LEFT VENTRICULAR SYSTOLIC DYSFUNCTION
KW - TESTING
UR - https://www.scopus.com/pages/publications/84857627803
U2 - 10.1249/MSS.0b013e318234316f
DO - 10.1249/MSS.0b013e318234316f
M3 - Article
C2 - 21900844
AN - SCOPUS:84857627803
SN - 0195-9131
VL - 44
SP - 371
EP - 376
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 3
ER -