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February 16, 2021HealthcareOpen Access

In patients taking beta-blockers, chronotropic incompetence was associated with significantly lower exercise capacity (18.3 vs. 24.0 mL/kg/min, p<0.001), regardless of beta-blocker dose.

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Why the study?

Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis, but its impact on exercise capacity remains unclear.

Does chronotropic incompetence reduce exercise capacity in patients taking beta-blockers?

Population

140 consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing

Comparison

Chronotropic incompetence (CI ≤ 62%) vs CI > 62%

Design

Observational study

Key result

In patients taking beta-blockers, chronotropic incompetence was associated with significantly lower exercise capacity (18.3 vs. 24.0 mL/kg/min, p<0.001), regardless of beta-blocker dose.

Authors

KSKrzysztof SmarżMTMaciej TysarowskiBZBeata Zaborska

Discussion

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Member takes

Overview

May warrant chronotropic assessment in beta-blocker patients with low exercise capacity; leaves open whether rate-targeted interventions improve tolerance.

Study Design

Type

Observational (n=140)

Structured PICO

Does chronotropic incompetence reduce exercise capacity in patients taking beta-blockers?

P
Population
140 consecutive patients taking beta-blockers (64% with heart failure, mean age 61 years) referred for cardiopulmonary exercise testing.
E
Exposure
Presence of chronotropic incompetence (defined as chronotropic index ≤ 62%)
C
Comparator
Absence of chronotropic incompetence (chronotropic index > 62%)
O
Outcome
Exercise capacity (EC) assessed as peak oxygen uptakesurrogate

Main Result

Absolute Event Rate: 18.3% vs 24%

p-value: p=<0.001

Chronotropic incompetence is highly prevalent in patients taking beta-blockers and is independently associated with significantly reduced aerobic exercise capacity, regardless of beta-blocker dose.

Cite This Study

Smarż et al. (2021) conducted an observational in Patients taking beta-blockers (n=140). Chronotropic incompetence (chronotropic index ≤ 62%) vs. No chronotropic incompetence was evaluated on Exercise capacity assessed as peak oxygen uptake (mL/kg/min) (p=<0.001). In patients taking beta-blockers, chronotropic incompetence was associated with significantly lower exercise capacity (18.3 vs. 24.0 mL/kg/min, p<0.001), regardless of beta-blocker dose.

synapsesocial.com/papers/6a6e2f15febe604dd707e896https://doi.org/10.3390/healthcare9020212
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers2020
  2. 2Chronotropic Incompetence, Beta-Blockers, and Functional Capacity in Advanced Congestive Heart Failure: Time to Pace?2007 · 80 citations
  3. 3Chronotropic incompetence - still on time to make a difference?2024
  4. 4Effect of β-Blocker Cessation on Chronotropic Incompetence and Exercise Tolerance in Patients With Advanced Heart Failure2012 · 22 citations
  5. 5Chronotropic Incompentence and Functional Capacity in Chronic Heart Failure: No Role of β‐Blockers and β‐Blocker Dose2010 · 58 citations