Key result
Pre-TAVI 2-minute heart rate recovery is linked to ~7% higher odds of functional improvement.
Why the study?
Heart rate recovery after exercise was hypothesized to predict outcomes in heart failure, prompting evaluation of its prognostic value for functional improvement in adults with severe aortic stenosis undergoing TAVI.
Does heart rate recovery after a 6-minute walk test predict functional improvement in adults with severe aortic stenosis undergoing TAVI?
Observational (n=93)
No
Does heart rate recovery after a 6-minute walk test predict functional improvement in adults with severe aortic stenosis undergoing TAVI?
Heart rate recovery after a 6-minute walk test is a simple, non-invasive predictor of functional improvement 3 months after TAVI.
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Pre-TAVI heart rate recovery may identify patients likely to gain exercise capacity after TAVI; hypothesis-generating and should not yet change practice.
BACKGROUND: It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI). METHODS: We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery. RESULTS: After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up. CONCLUSIONS: Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.
Aleksandrowicz et al. (2023) conducted an observational in Severe aortic stenosis (n=93). Heart rate recovery after 6-minute walk test was evaluated on Improvement in 6-minute walk test distance at 3 months post-TAVI (OR 1.068, 95% CI 1.012-1.128, p=0.017). Heart rate recovery after 2 minutes following a pre-procedural 6-minute walk test significantly predicted improvement in walking distance at 3 months post-TAVI (OR 1.068).
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