https://doi.org/10.4081/monaldi.2022.2265
Heart rate recovery in adult individuals with asthma
Submitted: March 21, 2022
Accepted: May 10, 2022
Published: May 13, 2022
Accepted: May 10, 2022
Abstract Views: 1077
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Slow heart rate recovery (HRR) after exercise is a predictor of overall mortality in individuals with and without cardiovascular or respiratory disorders. No data on adults with asthma are available. The purpose of the study is to evaluate the prevalence of slow HRR in these individuals as compared with those with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of baseline characteristics and physiological response to the six-minute walking distance test of stable individuals with asthma or COPD. Slow HRR was defined as HRpeak - HR at 1 minute after end exercise <12 bpm. Individuals with asthma walked significantly longer (median (IQR): 455 (385-512) vs 427 (345-485) meters; p=0.005) with a lower prevalence of slow HRR (30.3% vs 49.0%, respectively: p<0.001) than those with COPD. Individuals with asthma and slow HRR were older and walked less than those with normal HRR, without any difference in airway obstruction or in disease severity. Multivariate analysis showed that only the difference HRpeak - baseline HR (∆HR), was a predictor of slow HRR in both groups. More than 30% of adult individuals with asthma may show slow HRR. Only exercise ∆HR but no baseline characteristic seems to predict the occurrence of slow HRR.
Arai Y, Saul JP, Albrecht P, et al. Modulation of cardiac autonomic activity during and immediately after exercise. Am J Physiol 1989;256:H132-41.
DOI: https://doi.org/10.1152/ajpheart.1989.256.1.H132
Pierpont GL, Voth EJ. Assessing autonomic function by analysis of heart rate recovery from exercise in healthy subjects. Am J Cardiol 2004;94:64–8.
DOI: https://doi.org/10.1016/j.amjcard.2004.03.032
Cole CR, Blackstone EH, Pashkow FJ, et al. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 1999;341:1351-7.
DOI: https://doi.org/10.1056/NEJM199910283411804
Lacasse M, Maltais F, Poirier P, et al. Post-exercise heart rate recovery and mortality in chronic obstructive pulmonary disease. Respir Med 2005;99:877-86.
DOI: https://doi.org/10.1016/j.rmed.2004.11.012
Seshadri N, Gildea TR, McCarthy K, et al. Association of an abnormal exercise heart rate recovery with pulmonary function abnormalities. Chest 2004; 25:1286–91.
DOI: https://doi.org/10.1378/chest.125.4.1286
Cole CR, Foody JM, Blackstone EH, et al. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 2000;132:552.
DOI: https://doi.org/10.7326/0003-4819-132-7-200004040-00007
Qiu S, Cai X, Sun Z, et al. Heart rate recovery and risk of cardiovascular events and all‐cause mortality: A meta‐analysis of prospective cohort studies. J Am Heart Assoc 2017;6:e005505.
DOI: https://doi.org/10.1161/JAHA.117.005505
Nishime EO, Cole CR, Blackstone EH, et al. Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA 2000;284:1392-8.
DOI: https://doi.org/10.1001/jama.284.11.1392
Cahalin LP, Arena R, Labate V, et al. Heart rate recovery after the 6 min walk test rather than distance ambulated is a powerful prognostic indicator in heart failure with reduced and preserved ejection fraction: a comparison with cardiopulmonary exercise testing. Eur J Heart Fail 2013;15:519-27.
DOI: https://doi.org/10.1093/eurjhf/hfs216
Swigris JJ, Swick J, Wamboldt FS, et al. Heart rate recovery after 6-min walk test predicts survival in patients with idiopathic pulmonary fibrosis. Chest 2009;136:841-8.
DOI: https://doi.org/10.1378/chest.09-0211
Rodríguez DA, Kortianou EA, Alison JA, et al. Heart rate recovery after 6-min walking test predicts acute exacerbation in COPD. Lung 2017;195:463-7.
Gimeno-Santos E, Rodriguez DA, Barberan-Garcia A, et al. Endurance exercise training improves heart rate recovery in patients with COPD. COPD 2014;11:190-6.
DOI: https://doi.org/10.3109/15412555.2013.831401
Scalvini S, Porta R, Zanelli E, et al. Effects of oxygen on autonomic nervous system dysfunction in patients with chronic obstructive pulmonary disease. Eur Respir J 1999;13:119-24.
DOI: https://doi.org/10.1183/09031936.99.13111999
Pereira Silva É, Soares BA, Reimberg MM, et al. Heart rate recovery in asthmatic children and adolescents after clinical field test. BMC Pulm Med 2021;21:61.
DOI: https://doi.org/10.1186/s12890-020-01355-9
Maestri R, Bruschi C, Fracchia C, et al. Physiological and clinical characteristics of patients with COPD admitted to an inpatient pulmonary rehabilitation program: A real-life study. Pulmonology 2019;25:71-8.
DOI: https://doi.org/10.1016/j.pulmoe.2018.07.001
Zampogna E, Zappa M, Spanevello A, et al. Pulmonary rehabilitation and asthma. Front Pharmacol 2020;11 542.
DOI: https://doi.org/10.3389/fphar.2020.00542
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (2021 Update). Accessed: 20 September 2021. Available from: https://ginasthma.org/
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease Global Initiative for Chronic Obstructive Lung Disease. 2021 Report. Accessed: 20 September 2021. Available from: https://goldcopd.org/gold-reports/
Tu X, Donovan C, Kim RY, et al. Asthma-COPD overlap: current understanding and the utility of experimental models. Eur Respir Rev 2021;30:190185.
DOI: https://doi.org/10.1183/16000617.0185-2019
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD assessment test. Eur Respir J 2009;34:648-54.
DOI: https://doi.org/10.1183/09031936.00102509
Kurashima K, Takaku Y, Ohta C, et al. COPD assessment test and severity of airflow limitation in patients with asthma, COPD, and asthma-COPD overlap syndrome. Int J Chron Obstruct Pulmon Dis 2016;11:479-487.
DOI: https://doi.org/10.2147/COPD.S97343
Culver BH, Graham BL, Coates AL, et al. Recommendations for a Standardized Pulmonary Function Report. An Official American Thoracic Society Technical Statement. Am J Respir Crit Care Med 2017;196:1463-72.
DOI: https://doi.org/10.1164/rccm.201710-1981ST
Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012;40:1324-43.
DOI: https://doi.org/10.1183/09031936.00080312
Holland AE, Spruit MA, Troosters T, et al. An official European Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44:1428-46.
DOI: https://doi.org/10.1183/09031936.00150314
Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 1998;158:1384-7.
DOI: https://doi.org/10.1164/ajrccm.158.5.9710086
Poulain M, Durand F, Palomba B, et al. 6-minute walk testing is more sensitive than maximal incremental cycle testing for detecting oxygen desaturation in patients with COPD. Chest 2003;123:1401-7.
DOI: https://doi.org/10.1378/chest.123.5.1401
Rodríguez DA, Kortianou EA, Alison JA, et al. Heart rate recovery after 6-min walking test predicts acute exacerbation in COPD. Lung 2017;195:463-7.
DOI: https://doi.org/10.1007/s00408-017-0027-0
Milagro J, Hernández-Vicente A, Hernando D, et al. Nocturnal heart rate variability spectrum characterization in preschool children with asthmatic symptoms. IEEE J Biomed Health 2018;22:1332-40.
DOI: https://doi.org/10.1109/JBHI.2017.2775059
Gomes ELFD, Sampaio LMM, Carvalho EFT, et al. Comparative analysis of autonomic modulation in children with acute and controlled asthma. Med Sci Tech 2013;54:30-4.
DOI: https://doi.org/10.12659/MST.883863
Singh TP, Rhodes J, Gauvreau K. Determinants of heart rate recovery following exercise in children. Med Sci Sports Exerc 2008;40:601-5.
DOI: https://doi.org/10.1249/MSS.0b013e3181621ec4
Lewis MJ, Short AL, Lewis KE. Autonomic nervous system control of the cardiovascular and respiratory systems in asthma. Respir Med 2006;100:1688-705.
DOI: https://doi.org/10.1016/j.rmed.2006.01.019
Kaliner M, Shelhamer JH, Davis PB, et al. Autonomic nervous system abnormalities and allergy. Ann Intern Med 1982;96:349–57.
DOI: https://doi.org/10.7326/0003-4819-96-3-349
Barnes PJ, Brown MJ, Silverman M, et al. Circulating catecholamines in exercise and hyperventilation induced asthma. Thorax 1981;36:435–40.
DOI: https://doi.org/10.1136/thx.36.6.435
Warren JB, Keynes RJ, Brown MJ, et al. Blunted sympathoadrenal response to exercise in asthmatic subjects. Br J Dis Chest 1982;76:147-50.
DOI: https://doi.org/10.1016/0007-0971(82)90026-2
Inman MD, Watson RM, Killian KJ, et al. Methacholine airway responsiveness decreases during exercise in asthmatic subjects. Am Rev Respir Dis 1990;141:1414-7.
DOI: https://doi.org/10.1164/ajrccm/141.6.1414
Fujii H, Fukutomi O, Inoue R, et al. Autonomic regulation after exercise evidenced by spectral analysis of heart rate variability in asthmatic children. Ann Allergy Asthma Immunol 2000;85:233–7.
DOI: https://doi.org/10.1016/S1081-1206(10)62472-6
Kallenbach JM, Webster T, Dowdeswell R, et al. Reflex heart rate control in asthma: evidence of parasympathetic overactivity. Chest 1985;87:644–8.
DOI: https://doi.org/10.1378/chest.87.5.644
Horvath I, Argay K, Herjavecz I, et al. Relation between bronchial and cardiac vagal tone in healthy humans. Chest 1995;108:701–5.
DOI: https://doi.org/10.1378/chest.108.3.701
Gupta M, Bansal V, Chhabra SK. Abnormal heart rate recovery and chronotropic incompetence on exercise in chronic obstructive pulmonary disease. Chron Respir Dis 2013;10:117-26.
DOI: https://doi.org/10.1177/1479972313493097
Ba A, Delliaux S, Bregeon F, et al. Post-exercise heart rate recovery in healthy, obeses, and COPD subjects: relationships with blood lactic acid and PaO2 levels. Clin Res Cardiol 2009;98:52-8.
DOI: https://doi.org/10.1007/s00392-008-0723-0
Cholidou KG, Manali ED, Kapsimalis F, et al. Heart rate recovery post 6-minute walking test in obstructive sleep apnea: cycle ergometry versus 6-minute walking test in OSA patients. Clin Res Cardiol 2014;103:805-15.
DOI: https://doi.org/10.1007/s00392-014-0721-3
Shiroishi R, Kitagawa C, Miyamoto N, et al. Heart rate recovery after the 6-min walk test is related to 6-min walk distance and percutaneous oxygen saturation recovery in patients with COPD. Respirology 2015;20:671-3.
DOI: https://doi.org/10.1111/resp.12510
How to Cite
Zampogna, Elisabetta, Nicolino Ambrosino, Federico Mattia Oliva, Giovanni Sotgiu, Laura Saderi, Gioele Cremonese, Giorgio Bellelli, Antonio Spanevello, Fabio Angeli, and Dina Visca. 2022. “Heart Rate Recovery in Adult Individuals With Asthma”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2265.
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