Heart rate variability to assess ventilatory thresholds

Reliable in cardiac disease?

L. Mourot, N. Tordi, M. Bouhaddi, D. Teffaha, C. Monpere, J. Regnard

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The first (VT1) and second (VT2) ventilatory thresholds are landmarks to tailor exercise rehabilitation in coronary artery disease (CAD) or chronic heart failure (CHF). Methods allowing VT1 and VT2 determination based on heart rate variability (HRV) have been proposed but not yet evaluated in these patients. Design: To determine the heart rate (HR) associated with VT1 and VT2 by three methods of HRV analyses. Methods: Fourteen CHF and 24 CAD patients performed an exercise test on a cycle ergometer (10 -W every minute until exhaustion). VT1 and VT2 were determined with the 'respiratory equivalent' method. HR at VT1 was determined with the standard deviation (SD) of R-R intervals (VTSD) and of the instantaneous beat-to-beat variability of the Poincaré plot method (VTPoincaré). HR at VT1 and VT2 was determined through a time-varying HRV analysis method (VTTV1 and VTTV2, respectively). Results: HR at VTSD was significantly higher than HR at VT1. No significant differences were observed between HR at VTPoincaré, VTTV1, and at VT1, nor between HR at VTTV2 and VT2. HR at VTSD, VT Poincaré, and VT1 were significantly correlated, but with a low r2 value and a large mean HR difference. With the time-varying method, the mean HR difference was lower than 5% and the correlation coefficients were higher (especially for VTTV2). Conclusions: SD and Poincaré plot methods lead to substantial inaccuracy in HR estimates. The time-varying HRV analysis led to strong correlation coefficients and low limits of agreement. Therefore, this method may be a promising, low-cost tool for non-invasive assessment of the ventilatory thresholds in cardiac disease.

Original languageEnglish
Pages (from-to)1272-1280
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume19
Issue number6
DOIs
Publication statusPublished - 1 Dec 2012
Externally publishedYes

Fingerprint

Heart Diseases
Heart Rate
Coronary Artery Disease
Heart Failure
Exercise Therapy
Exercise Test
Costs and Cost Analysis

Keywords

  • Coronary heart disease
  • heart failure
  • incremental exercise
  • testing
  • time-varying analysis
  • ventilation

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

Cite this

Heart rate variability to assess ventilatory thresholds : Reliable in cardiac disease? / Mourot, L.; Tordi, N.; Bouhaddi, M.; Teffaha, D.; Monpere, C.; Regnard, J.

In: European Journal of Preventive Cardiology, Vol. 19, No. 6, 01.12.2012, p. 1272-1280.

Research output: Contribution to journalArticle

Mourot, L. ; Tordi, N. ; Bouhaddi, M. ; Teffaha, D. ; Monpere, C. ; Regnard, J. / Heart rate variability to assess ventilatory thresholds : Reliable in cardiac disease?. In: European Journal of Preventive Cardiology. 2012 ; Vol. 19, No. 6. pp. 1272-1280.
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abstract = "Background: The first (VT1) and second (VT2) ventilatory thresholds are landmarks to tailor exercise rehabilitation in coronary artery disease (CAD) or chronic heart failure (CHF). Methods allowing VT1 and VT2 determination based on heart rate variability (HRV) have been proposed but not yet evaluated in these patients. Design: To determine the heart rate (HR) associated with VT1 and VT2 by three methods of HRV analyses. Methods: Fourteen CHF and 24 CAD patients performed an exercise test on a cycle ergometer (10 -W every minute until exhaustion). VT1 and VT2 were determined with the 'respiratory equivalent' method. HR at VT1 was determined with the standard deviation (SD) of R-R intervals (VTSD) and of the instantaneous beat-to-beat variability of the Poincar{\'e} plot method (VTPoincar{\'e}). HR at VT1 and VT2 was determined through a time-varying HRV analysis method (VTTV1 and VTTV2, respectively). Results: HR at VTSD was significantly higher than HR at VT1. No significant differences were observed between HR at VTPoincar{\'e}, VTTV1, and at VT1, nor between HR at VTTV2 and VT2. HR at VTSD, VT Poincar{\'e}, and VT1 were significantly correlated, but with a low r2 value and a large mean HR difference. With the time-varying method, the mean HR difference was lower than 5{\%} and the correlation coefficients were higher (especially for VTTV2). Conclusions: SD and Poincar{\'e} plot methods lead to substantial inaccuracy in HR estimates. The time-varying HRV analysis led to strong correlation coefficients and low limits of agreement. Therefore, this method may be a promising, low-cost tool for non-invasive assessment of the ventilatory thresholds in cardiac disease.",
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AU - Bouhaddi, M.

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AU - Regnard, J.

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AB - Background: The first (VT1) and second (VT2) ventilatory thresholds are landmarks to tailor exercise rehabilitation in coronary artery disease (CAD) or chronic heart failure (CHF). Methods allowing VT1 and VT2 determination based on heart rate variability (HRV) have been proposed but not yet evaluated in these patients. Design: To determine the heart rate (HR) associated with VT1 and VT2 by three methods of HRV analyses. Methods: Fourteen CHF and 24 CAD patients performed an exercise test on a cycle ergometer (10 -W every minute until exhaustion). VT1 and VT2 were determined with the 'respiratory equivalent' method. HR at VT1 was determined with the standard deviation (SD) of R-R intervals (VTSD) and of the instantaneous beat-to-beat variability of the Poincaré plot method (VTPoincaré). HR at VT1 and VT2 was determined through a time-varying HRV analysis method (VTTV1 and VTTV2, respectively). Results: HR at VTSD was significantly higher than HR at VT1. No significant differences were observed between HR at VTPoincaré, VTTV1, and at VT1, nor between HR at VTTV2 and VT2. HR at VTSD, VT Poincaré, and VT1 were significantly correlated, but with a low r2 value and a large mean HR difference. With the time-varying method, the mean HR difference was lower than 5% and the correlation coefficients were higher (especially for VTTV2). Conclusions: SD and Poincaré plot methods lead to substantial inaccuracy in HR estimates. The time-varying HRV analysis led to strong correlation coefficients and low limits of agreement. Therefore, this method may be a promising, low-cost tool for non-invasive assessment of the ventilatory thresholds in cardiac disease.

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KW - heart failure

KW - incremental exercise

KW - testing

KW - time-varying analysis

KW - ventilation

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