Is Age-Predicted Maximal Heart Rate Applicable in Patients With Heart or Lung Disease?

다국어 초록 (Multilingual Abstract)

Objective To compare the predicted and actual maximal heart rate (HRmax) values in the cardiopulmonary exercise test (CPET).Methods We retrospectively investigated 1,060 patients who underwent a CPET between January 2016 and April 2020 at our institution’s cardiopulmonary rehabilitation center. The following patients were included: those aged >20 years, those tested with a treadmill, and those who underwent symptom-limited maximum exercise testing—reaching ≥85% of the predicted HRmax (62% if taking beta-blockers) and highest respiratory exchange ratio ≥1.1. Ultimately, 827 patients were included in this study. Data on diagnosis, history of taking beta-blockers, age, body mass index (BMI), and CPET parameters were collected. Subgroup analysis was performed according to age, beta-blockers, BMI (low <18.5 kg/m2, normal, and high ≥25 kg/m2), and risk classification.Results There was a significant difference between the actual HRmax and the predicted value (p<0.001). Beta-blocker administration resulted in a significant difference in the actual HRmax (p<0.001). There were significant differences in the moderate-to-high-risk and low-risk groups and the normal BMI and high BMI groups (p<0.001). There was no significant difference between the elderly and younger groups. We suggest new formulae for HRmax of cardiopulmonary patients: estimated HRmax=183-0.76×age (the beta-blocker group) and etimated HRmax=210-0.91×age (the non-beta-blocker group).Conclusion Age-predicted HRmax was significantly different from the actual HRmax of patients with cardiopulmonary disease, especially in the beta-blocker group. For participants with high BMI and moderate-to-severe risk, the actual HRmax was significantly lower than the predicted HRmax.

참고문헌 (Reference)

1 Esposito F, "Validity of heart rate as an indicator of aerobic demand during soccer activities in amateur soccer players" 93 : 167-172, 2004

2 Robergs RA, "The surprising history of the"HRmax=220-age"equation" 5 : 1-10, 2002

3 Li S, "Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery : does the ‘obesity paradox’ really exist?" 51 : 817-828, 2017

4 Hills AP, "Submaximal markers of exercise intensity" 16 (16): S71-S76, 1998

5 Salati M, "Risk stratification in lung resection" 4 : 37-, 2016

6 Lewis GD, "Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases" 128 : 1470-1479, 2013

7 Hong SP, "Prognostic value of heart rate reserve in exercise treadmill test after coronary revascularization" 4 : 175-, 2014

8 Miller WC, "Predicting max HR and the HR-VO2 relationship for exercise prescription in obesity" 25 : 1077-1081, 1993

9 Fox SM 3rd, "Physical activity and the prevention of coronary heart disease" 3 : 404-432, 1971

10 Zewari S, "Obesity in COPD : revealed and unrevealed issues" 14 : 663-673, 2017

11 Lafortuna CL, "Metabolic responses to submaximal treadmill walking and cycle ergometer pedalling in obese adolescents" 20 : 630-637, 2010

12 Wonisch M, "Influence of beta-blocker use on percentage of target heart rate exercise prescription" 10 : 296-301, 2003

13 Londeree BR, "Influence of age and other factors on maximal heart rate" 4 : 44-49, 1984

14 Sporis G, "How reliable are the equations for predicting maximal heart rate values in military personnel?" 176 : 347-351, 2011

15 Karvonen J, "Heart rate and exercise intensity during sports activities : practical application" 5 : 303-311, 1988

16 Ozeki N, "Factors associated with changes in the 12-m stair-climbing time after lung lobectomy" 69 : 282-289, 2021

17 Kligfield P, "Exercise electrocardiogram testing : beyond the ST segment" 114 : 2070-2082, 2006

18 Sebastian LA, "Determining target heart rate for exercising in a cardiac rehabilitation program : a retrospective study" 30 : 164-171, 2015

19 Toner MM, "Cardiorespiratory responses to exercise distributed between the upper and lower body" 54 : 1403-1407, 1983

20 Albouaini K, "Cardiopulmonary exercise testing and its application" 83 : 675-682, 2007

21 Khan SS, "Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity" 3 : 280-287, 2018

22 Strait JB, "Aging-associated cardiovascular changes and their relationship to heart failure" 8 : 143-164, 2012