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Volume 9
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10.3390/healthcare9020212
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Article

Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients

by
Krzysztof Smarz
1,*,†,
Maciej Tysarowski
1,2,†,
Beata Zaborska
1,
Ewa Pilichowska-Paszkiet
1,
Małgorzata Sikora-Frac
1,
Andrzej Budaj
1 and
Tomasz Jaxa-Chamiec
1
1
Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, Poland
2
Department of Medicine, Rutgers University New Jersey Medical School, Newark, NJ 07103, USA
*
Author to whom correspondence should be addressed.
†
Both Smarz and Tysarowski contributed equally as first authors to this study.
Healthcare 2021, 9(2), 212; https://doi.org/10.3390/healthcare9020212
Submission received: 14 December 2020 / Revised: 31 January 2021 / Accepted: 10 February 2021 / Published: 16 February 2021
(This article belongs to the Section Health Assessments)
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Abstract

Background: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear. Methods: We analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing to assess EC. Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%. Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), 64% with heart failure, chronotropic incompetence was present in 80.7%. EC assessed as peak oxygen uptake was lower in the group with chronotropic incompetence, 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, p < 0.001. EC correlated positively with CI (β = 0.14, p < 0.001) and male gender (β = 5.12, p < 0.001), and negatively with age (β = −0.17, p < 0.001) and presence of heart failure (β = −3.35, p < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI accounted for more than one-third of the variance in EC explained by the model (adjusted R2 = 59.8%). Conclusions: In patients taking beta-blockers, presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.
Keywords: adrenergic beta antagonists; chronotropic incompetence; chronotropic index; exercise capacity; exercise test; oxygen uptake adrenergic beta antagonists; chronotropic incompetence; chronotropic index; exercise capacity; exercise test; oxygen uptake

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MDPI and ACS Style

Smarz, K.; Tysarowski, M.; Zaborska, B.; Pilichowska-Paszkiet, E.; Sikora-Frac, M.; Budaj, A.; Jaxa-Chamiec, T. Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients. Healthcare 2021, 9, 212. https://doi.org/10.3390/healthcare9020212

AMA Style

Smarz K, Tysarowski M, Zaborska B, Pilichowska-Paszkiet E, Sikora-Frac M, Budaj A, Jaxa-Chamiec T. Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients. Healthcare. 2021; 9(2):212. https://doi.org/10.3390/healthcare9020212

Chicago/Turabian Style

Smarz, Krzysztof, Maciej Tysarowski, Beata Zaborska, Ewa Pilichowska-Paszkiet, Małgorzata Sikora-Frac, Andrzej Budaj, and Tomasz Jaxa-Chamiec. 2021. "Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients" Healthcare 9, no. 2: 212. https://doi.org/10.3390/healthcare9020212

APA Style

Smarz, K., Tysarowski, M., Zaborska, B., Pilichowska-Paszkiet, E., Sikora-Frac, M., Budaj, A., & Jaxa-Chamiec, T. (2021). Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients. Healthcare, 9(2), 212. https://doi.org/10.3390/healthcare9020212

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