089 Heart rate recovery is a powerful prognostic factor in patients with chronic heart failure

Background Heart rate recovery (HRR) prognostic value is well established in patients with coronary artery disease but poorly documented in patients with heart failure (HF) and not established in those with advanced HF. Methods 144 patients with compensated HF underwent cardiopulmonary exercise testing (CPX) and were followed for a combined death/transplantation/hospitalization end point. Patients with advanced HF were defined as those with peak VO2 ≤ 14 ml/kg/mn (n = 41/144; 28%). Mean age and left ventricular ejection fraction (LVEF) were 53 ± 12 years and 29 ± 7% respectively in all population and 58 ± 11 years and 28 ± 7% respectively in the advanced HF group. Ninety one percent of patients received betablockers (93% in advanced HF group). HRR at 1-minute post-CPX was calculated as the difference between heart rate at peak exercise and after 1 minute of active recovery. Results Among the 144 patients, we recorded 10 mortality, 7 cardiac transplantation and 8 hospitalization for acute HF outcome events over 16 months of follow-up. The baseline mean peak respiratory exchange ratio (RER), peak VO2, VE/VCO2 slope, and HRR1 were 1.13 ± 0.09, 16 ± 4 ml/kg/mn, 35 ± 8, 13 ± 12 beat/mn, respectively. Although LVEF, peak VO2, VE/VCO2 slope and HRR1 were significant univariate predictors of the composite end point (p  5 bpm (logrank = 5, p = 0.02) (HR = 2.66; CI: 2.08–2.66, p = 0.02). Conclusions HRR is an easily measured noninvasive variable that can be used to further prognostically risk stratify patients with advanced HF.