Heart Rate Recovery, Physical Activity Level, and Functional Status in Subjects With COPD

• Published in: Respiratory care 2018-08, Vol.63 (8), p.1002-1008
• Main Authors: Morita, Andrea A, Silva, Laís K O, Bisca, Gianna W, Oliveira, Joice M, Hernandes, Nidia A, Pitta, Fabio, Furlanetto, Karina C
• Format: Article
• Language: English
• Subjects: Analysis; Care and treatment; Chronic obstructive lung disease; Diagnosis; Exercise; Health aspects; Heart rate; Outcome and process assessment (Medical care)
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.05918

A normal heart rate reflects the balance between the sympathetic and parasympathetic autonomic nervous system. When the difference between heart rate at the end of an exercise test and after 1 min of recovery, known as the 1-min heart rate recovery, is ≤ 12 beats/min, this may indicate an abnormal delay. We sought to compare physical activity patterns and subjects' functional status with COPD with or without delayed 1-min heart rate recovery after the 6-min walk test (6MWT). 145 subjects with COPD (78 men, median [interquartile range (IQR)] age 65 [60-73] y, body mass index 25 [21-30] kg/m , FEV 45 ± 15% predicted) were underwent the following assessments: spirometry, 6MWT, functional status, and physical activity in daily life (PADL). A delayed heart rate recovery of 1 min was defined as ≤ 12 beats/min. Subjects with delayed 1-min heart rate recovery walked a shorter distance in the 6MWT compared to subjects without delayed heart rate recovery (median [IQR] 435 [390-507] m vs 477 [425-515] m, = .01; 81 [71-87] vs 87 [79-98]% predicted, = .002). Regarding PADL, subjects with delayed heart rate recovery spent less time in the standing position (mean ± SD 185 ± 89 min vs 250 ± 107 min, = .002) and more time in sedentary positions (472 ± 110 min vs 394 ± 129 min, = .002). Scores based on the self-care domain of the London Chest Activity of Daily Living questionnaire and the activity domain of the Pulmonary Functional Status and Dyspnea questionnaire were also worse in the group with delayed heart rate recovery (6 ± 2 points vs 5 ± 2 points; = .039 and 29 ± 24 points vs 19 ± 17 points; = .037, respectively). Individuals with COPD who exhibit delayed 1-min heart rate recovery after the 6MWT exhibited worse exercise capacity as well as a more pronounced sedentary lifestyle and worse functional status than those without delayed heart rate recovery. Despite its assessment simplicity, heart rate recovery after the 6MWT can be further explored as a promising outcome in COPD.