Key result
Impaired chronotropic response during a 6MWT is linked to ~18% higher mortality.
Why the study?
Does an impaired chronotropic response during a 6-min walk test predict mortality and incident coronary heart disease in older adults?
Cohort (n=2,224)
Does an impaired chronotropic response during a 6-min walk test predict mortality and incident coronary heart disease in older adults?
Impaired chronotropic response during a 6-minute walk test is associated with increased mortality and incident coronary heart disease in older adults, though this association is attenuated by exercise capacity.
OBJECTIVES: To determine the relationship between heart rate response during low-grade physical exertion (6-min walk) with mortality and adverse cardiovascular outcomes in the elderly. METHODS: Participants in the Cardiovascular Health Study who completed a 6-min walk test were included. We used delta heart rate (difference between postwalk heart rate and resting heart rate) as a measure of chronotropic response and examined its association with (1) all-cause mortality and (2) incident coronary heart disease event, using multivariable Cox regression models. RESULTS: We included 2,224 participants (mean age 77 ± 4 years; 60% women; 85% white). The average delta heart rate was 26 beats/min. Participants in the lowest tertile of delta heart rate (<20 beats/min) had higher risk-adjusted mortality [hazard ratio (HR) 1.18, 95% confidence interval (CI) 1.00-1.40] and incident coronary heart disease (HR 1.37, 95% CI 1.05-1.78) compared to subjects in the highest tertile (≥30 beats/min), with a significant linear trend across tertiles (p for trend <0.05 for both outcomes). This relationship was not significant after adjustment for distance walked. CONCLUSION: Impaired chronotropic response during a 6-min walk test was associated with an increased risk of mortality and incident coronary heart disease among the elderly. This association was attenuated after adjusting for distance walked.
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Girotra et al. (2012) conducted a cohort in Older adults (n=2,224). Impaired chronotropic response (delta heart rate <20 beats/min) vs. Highest tertile of delta heart rate (≥30 beats/min) was evaluated on all-cause mortality (HR 1.18, 95% CI 1.00-1.40, p=<0.05). An impaired chronotropic response (<20 beats/min) during a 6-minute walk test was associated with higher mortality (HR 1.18; 95% CI 1.00-1.40) compared to a response ≥30 beats/min.
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