Exercise chronotropy in patients with normal and impaired sinus node function after cardiac transplantation

Autor: Christoph Kratochwill, Mighael Grimm, Gottfried Heinz, Susanne Radosztics, Gere Sunder-Plassmann, Heinz Gössinger, Gerhard Kreiner, Axel Lagzkovics, Peter Buxbaum, Günther Laufer
Rok vydání: 1993
Předmět:
Zdroj: Pacing and clinical electrophysiology : PACE. 16(9)
ISSN: 0147-8389
Popis: The chronotropic response during graded, symptom limited exercise was investigated in 32 cardiac transplant recipients a mean of 49 +/- 18 days after transplantation. All patients had systematic evaluation of postoperative donor sinus node (SN) function and the cardioacceleratory response was compared according to the SN function. Twenty-one patients had normal postoperative SN studies (corrected SN recovery time520 msec, group I) while the SN function was impaired postoperatively in the remainder (n = 11, group II; corrected SN recovery time 4,149 +/- 6,283 msec in 5 patients, junctional escape rhythm in 6 patients). All patients had regained sinus rhythm at time of the exercise test. Patients in group II had lower basal sinus rates at the beginning of exercise (91.5 +/- 11 vs 101.4 +/- 7 beats/min, P0.02). This lower chronotropy was maintained over every incremental step (F rate between groups = 30, P = 0.0001, F rate vs workload = 15, P = 0.0001 by two-way ANOVA) and resulted in a significantly lower heart rate at individual peak exercise (108.3 +/- 20 vs 124.2 +/- 13 beats/min, P0.02). A total of 14/16 patients in group I but only 2/16 patients in group II accomplished a peak heart rateor = 120 beats/min (P = 0.009). The workload achieved did not differ between the groups (107 +/- 29 vs 102 +/- 32 watts, P0.5). These data show a lower SN chronotropy during rest and at peak exercise in cardiac transplant recipients with postoperative SN deficiency and apparent normalization of SN function.
Databáze: OpenAIRE
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