Authors

1. Maldonado-Martin, Sara PhD
2. Brubaker, Peter H. PhD
3. Ozemek, Cemal PhD
4. Jayo-Montoya, Jon A. MS
5. Becton, J. Thomas PhD
6. Kitzman, Dalane W. MD

Abstract

Purpose: The study aimed to investigate the differences in oxygen uptake (

O₂) and heart rate (HR) (at rest, submaximal exercise, peak exercise, and recovery) in patients with heart failure with preserved ejection fraction (HFpEF) with [beta]-blockers (BB) or without BB treatment (NBB) and to analyze the relationship between HR reserve (HR_resv) and peak

O₂ (

O_2peak) in BB and NBB.

Methods: A total of 174 HFpEF patients (>65 yr; BB, n = 59; NBB, n = 115) were assessed with a cardiopulmonary exercise test to peak exertion using an incremental protocol. After 5 min of supine rest, HR and

O₂ (HR_rest,

O_2rest) at submaximal exercise (HR_submax,

O_2submax), at peak exercise (HR_peak,

O_2peak), at 1 min of passive recovery (HR_rec1), HR_resv (HR_peak- HR_rest), and HR recovery (HR_recov = HR_peak- HR_rec1) were evaluated.

Results: Analysis showed that HR_rest (66.0 +/- 12.2 vs 69.7 +/- 10.6 bpm), HR_submax (91.7 +/- 16.2 vs 98.6 +/- 15.2 bpm), and HR_rec1 (102.9 +/- 18.9 vs 109.4 +/- 16.9 bpm) were significantly lower (P <= .05) in BB than in NBB, respectively. However, there were no significant differences (P > .05) between the BB and the NBB for HR_peak, HR_resv, HR_recov,

O_2rest,

O_2submax, and

O_2peak. A significant relationship was found between HR_resv and

O_2peak values in both groups (BB, r = 0.52; NBB, r = 0.49, P < .001).

Conclusions: The nonsignificant differences in HR_peak, HR_resv, HR_recov, or

O₂ values between BB and NBB HFpEF patients, along with significant correlation between HR_resv and

O_2peak, suggest that these measures may have equal utility in prognostic and functional assessment as well as clinical applications, including the prescription of exercise, in elderly HFpEF patients.