Abstract
Introduction: Chronotropic Incompetence (CI), or an attenuated heart rate (HR) response to exercise, has been widely established as a predictor of mortality but has not been studied in patients undergoing lung transplantation.
Objectives: We aimed to see whether CI in maximal exercise testing exists in patients with advanced lung disease before lung transplantation and improves after surgery.
Methods: A retrospective review of 153 patients who underwent lung transplantation at Columbia University Lung Transplant Program between 6/2002 and 4/2009. Patients had cardiopulmonary exercise testing (CPET) within 30 months before or after transplant with concurrent with pulmonary function tests (PFT). Exclusion criteria included the use of beta-blockers. Comparisons were made with paired samples t-test.
Results: The mean PFT and CPET variables for the 71 patients (age 50±15 years) analyzed are shown in table 1.
Conclusions: Marked CI was observed before lung transplantation and improved afterwards but did not normalize. CI likely improved due to the normalization of pulmonary function post transplant. This was seen through a lower resting HR and a higher maximal HR. The implications of CI are not clear and warrant further investigation, including evaluation of the association of CI and morality after transplant.
- © 2011 ERS