| Title |
Rate-Response Programming Tailored to the Force-Frequency Relationship Improves Exercise Tolerance in Chronic Heart Failure
|
|---|---|
| Published in |
JACC: Heart Failure, December 2017
|
| DOI | 10.1016/j.jchf.2017.09.018 |
| Pubmed ID | |
| Authors |
John Gierula, Maria F. Paton, Judith E. Lowry, Haqeel A. Jamil, Rowenna Byrom, Michael Drozd, Jack O. Garnham, Richard M. Cubbon, David A. Cairns, Mark T. Kearney, Klaus K. Witte |
| Abstract |
This study sought to examine whether the heart rate (HR) at which the force-frequency relationship (FFR) slope peaks (critical HR) could be used to tailor HR response in chronic heart failure (CHF) patients with cardiac pacemakers and whether this favorably influences exercise capacity. CHF secondary to left ventricular (LV) systolic dysfunction is characterized by blunting of the positive relationship between HR and LV contractility known as the FFR. This observational study was carried out in patients with CHF and healthy subjects with pacemaker devices. The study assessed the 3 important features of the FFR (critical HR, peak contractility, and the FFR slope), and their reproducibility was measured noninvasively using echocardiography. The investigators then undertook a double-blind, randomized, controlled crossover study comparing the effects of tailored pacemaker rate-response programming on the basis of the FFR with conventional rate-response programming on exercise time and maximal oxygen consumption. The study enrolled 90 patients with CHF into the observational cohort study: mean age, 73.6 ± 8.9 years; mean left ventricular ejection fraction (LVEF), 33.5 ± 10.9%. The study investigated 15 control subjects with normal LV function (LVEF, 55.6 ± 5.3%). The critical HR (103 ± 22 beats/min vs. 126 ± 15 beats/min; p = 0.0002), peak contractility (3.8 ± 3.7 SBP/LVESVI vs. 9.8 ± 4.1 SPB/LVESVI; p = 0.0001), and the slope of the FFR (p < 10-15) were lower in patients with CHF than in control subjects. A total of 52 patients, with a mean LVEF of 32 ± 11% on optimal therapy, took part in the crossover study. Rate-response settings limiting HR rise to below the critical HR led to greater exercise time (475 ± 189 s vs. 425 ± 196 s; p = 0.003) and higher peak oxygen consumption (17.3 ± 4.6 ml/kg/min vs. 16.6 ± 4.7 ml/kg/min; p = 0.01). A personalized approach to rate-response programming, determined using a reproducible noninvasive method for assessing the FFR, improves exercise time in patients with CHF and pacemaker devices. (Bowditch Revisited: Defining the Optimum Heart Rate Range in Chronic Heart Failure; NCT02563873). |
X Demographics
The data shown below were collected from the profiles of 28 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 14 | 50% |
| United States | 2 | 7% |
| Nigeria | 1 | 4% |
| Unknown | 11 | 39% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 18 | 64% |
| Scientists | 5 | 18% |
| Practitioners (doctors, other healthcare professionals) | 4 | 14% |
| Science communicators (journalists, bloggers, editors) | 1 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 70 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 9 | 13% |
| Student > Master | 7 | 10% |
| Researcher | 6 | 9% |
| Professor > Associate Professor | 5 | 7% |
| Student > Ph. D. Student | 5 | 7% |
| Other | 11 | 16% |
| Unknown | 27 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 30% |
| Nursing and Health Professions | 7 | 10% |
| Computer Science | 2 | 3% |
| Sports and Recreations | 2 | 3% |
| Agricultural and Biological Sciences | 1 | 1% |
| Other | 5 | 7% |
| Unknown | 32 | 46% |
Attention Score in Context
This research output has an Altmetric Attention Score of 29. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 December 2022.
All research outputs
#1,358,631
of 25,382,440 outputs
Outputs from JACC: Heart Failure
#432
of 1,583 outputs
Outputs of similar age
#30,378
of 446,025 outputs
Outputs of similar age from JACC: Heart Failure
#13
of 43 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,583 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.2. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 446,025 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 43 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.