Key result
Delayed heart rate recovery at 1-minute post-cardiopulmonary exercise testing (≤14 beats/min) independently predicted acute exacerbations in patients with moderate COPD (HR 8.35).
Why the study?
Heart rate recovery at 1 min after cardiopulmonary exercise testing indicates autonomic function, but its role in predicting COPD progression is not well understood or widely utilized.
Does abnormal heart rate recovery after cardiopulmonary exercise testing predict acute exacerbations in patients with moderate COPD?
Cohort (n=60)
No
Does abnormal heart rate recovery after cardiopulmonary exercise testing predict acute exacerbations in patients with moderate COPD?
Hazard Ratio: 8.35 (95% CI 2.3–30.04)
Absolute Event Rate: 78.95% vs 14.63%
p-value: p=0.001
Delayed heart rate recovery at 1-minute post-CPET (≤14 bpm) is an independent predictor of acute exacerbations in patients with moderate COPD, suggesting its utility as a risk stratification tool.
HRR1 after CPET may identify higher AECOPD risk in COPD; leaves open whether it adds value beyond established predictors in prospective validation.
Background: Automatic dysfunction is present in patients with Chronic Obstructive Pulmonary Disease (COPD). Heart rate recovery at 1 min (HRR1) after Cardiopulmonary Exercise Testing (CPET) serves an indicator of automatic function. Despite its potential significance, this primary method is still not well understood or widely utilized in predicting the progression of COPD. This study aimed to determine whether this indicator predicts acute exacerbations of COPD (AECOPD). Methods: In this prospective cohort study, 62 patients with COPD were recruited from 2013 to 2017. All participants underwent CPET test and followed up for 5 years thereafter. Univariate and multivariate linear regression, as well as Cox regression, were utilized to identify the abnormal HRR1 and the variables influencing AECOPD. Results: HRR1 after CPET was a significant correlation of COPD progression. According to the Receiver Operating Characteristic curve, 14 beats/min for HRR1 was optimally used to measure the characteristics of COPD patients. HRR1≤ 14 beats/min significantly predicted the time to the first AECOPD ( p =0.00032, Log rank test). In the Cox proportional hazard models, HRR1≤ 14 beats/min was also consistently correlated with AECOPD occurrence (Hazards ratio=8.30, p =0.001). Conclusion: HRR1 after CPET was an independent predictor of AECOPD. Thus, this index can be applied to observe the conditions and treatment results of COPD patients.
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Nie et al. (2025) conducted a cohort in Moderate Chronic Obstructive Pulmonary Disease (COPD) (n=60). Heart rate recovery at 1 min (HRR1) ≤ 14 beats/min after Cardiopulmonary Exercise Testing vs. HRR1 > 14 beats/min was evaluated on Occurrence of acute exacerbations of COPD (AECOPD) (HR 8.35, 95% CI 2.30-30.04, p=0.001). Delayed heart rate recovery at 1-minute post-cardiopulmonary exercise testing (≤14 beats/min) independently predicted acute exacerbations in patients with moderate COPD (HR 8.35).
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