Real-Time Estimation of Anaerobic Threshold during Exercise Using Electrocardiogram in Heart Failure Patients

Author:

Ryuzaki Toshinobu12,Shiraishi Yasuyuki12ORCID,Miura Kotaro12,Ikura Hidehiko12,Seki Yuta12ORCID,Azuma Koichiro2,Sato Kazuki2,Fukuda Keiichi1,Katsumata Yoshinori12ORCID

Affiliation:

1. Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan

2. Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan

Abstract

Exercise therapy at the aerobic level is highly recommended to improve clinical outcomes in patients with heart failure, in which cardiopulmonary exercise testing (CPX) is required to determine anaerobic thresholds (ATs) but is not available everywhere. This study aimed to validate a method to estimate the AT using heart rate variability (HRV) analysis from electrocardiography data in patients with heart failure. Between 2014 and 2019, 67 patients with symptomatic heart failure underwent CPXs in a single university hospital. During the CPX, RR intervals was measured continuously and the HRV threshold (HRVT), defined as the inflection point of <5 ms2 of a high-frequency component (HFC) using the power spectrum analysis, was determined. Patients were divided into two groups according to the mean HFC at rest (high-HFC group, n = 34 and low-HFC group, n = 33). The high-HFC group showed good correlation between the VO2 at AT and HRVT (r = 0.63, p < 0.001) and strong agreement (mean difference, −0.38 mL/kg, p = 0.571). The low-HFC group also showed modest correlation (r = 0.41, p = 0.017) but poor agreement (mean differences, 3.75 mL/kg, p < 0.001). In conclusion, the HRVT obtained from electrocardiography may be a useful indicator for estimating AT in patients with heart failure.

Funder

SECOM Science and Technology Foundation

Uehara Memorial Foundation

Publisher

MDPI AG

Subject

General Medicine

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