Key result
Age and heart rate change during the six-minute walk test were significant independent determinants of heart rate recovery in lung cancer survivors eligible for long-term cure.
Why the study?
Lung cancer survivors are at increased risk for autonomic dysfunction, but the determinants of parasympathetic nervous system function in those eligible for long-term cure were not identified.
Cross-Sectional (n=69)
No
Effect estimate: β 0.17 (95% CI 0.04-0.30)
In lung cancer survivors eligible for long-term cure, heart rate recovery and heart rate variability are inter-dependent measures of parasympathetic nervous system function that may be useful for risk stratification.
May inform autonomic risk assessment in lung cancer survivors; leaves open causal links and clinical utility pending prospective studies.
Background Lung cancer survivors are at increased risk for autonomic dysfunction. We aimed to identify determinants of parasympathetic nervous system (PNS) function as reflected by heart rate recovery (HRR) and heart rate variability (HRV) in lung cancer survivors eligible for long-term cure. Methods We performed a cross-sectional study of consecutive lung cancer survivors who completed curative-intent therapy for stage I-IIIA ≥1 month previously. We tested a comprehensive list of variables related to baseline demographics, comorbidities, lung cancer characteristics, and physiological/functional measures using univariable and multivariable (MVA) linear regression analyses. We defined HRR as the difference in heart rate (HR) at 1-minute following and the end of the six-minute walk test (6MWT), and HRV the standard deviation of normal-to-normal R-R intervals (SDNN) and root-mean-square-of-successive-differences (rMSSD) from routine single 10-s electrocardiographs (ECGs). Results In 69 participants, the mean (standard deviation, SD) HRR was -10.6 (6.7) beats. In MVAs, significant independent determinants of HRR [β (95% confidence interval)] were: age [0.17 (0.04, 0,30) for each year ] and HR change associated with the 6MWT [0.01 (0.007, 0.02) for each beats/min. In 41 participants who had ECGs available for HRV measurements, the mean (SD) SDNN and rMSSD were 19.1 (15.6) and rMSSD 18.2 (14.6) ms, respectively. In MVAs, significant determinants of HRV were: total lung capacity [0.01 (0.00, 0.02), p=0.047 for each % predicted ] and HRR [-0.04 (-0.07, -0.003) for each beat ] for natural logarithm (Ln-)SDNN; and [0.01 (0.00, 0.02)] and [-0.04 (-0.07, -0.01)] for Ln-rMSSD, respectively. Conclusions We measured determinants of HRR and HRV in lung cancer survivors eligible for long-term cure. HRR and/or HRV may be useful as indicators to stratify patients in interventional studies aimed at improving PNS function in lung cancer survivors, including through exercise training.
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Ha et al. (2018) conducted a cross-sectional in Lung cancer (n=69). Clinical and physiological characteristics (e.g., age, total lung capacity) was evaluated on Determinants of Heart Rate Recovery (HRR) (β 0.17, 95% CI 0.04-0.30). Age and heart rate change during the six-minute walk test were significant independent determinants of heart rate recovery in lung cancer survivors eligible for long-term cure.
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