Randomized Controlled Trial Journal Article Research Support, N.I.H., Extramural Ppublish 2 citations
PubMed: 38578959 DOI: 10.1097/QAD.0000000000003840
Association of chronotropic incompetence with reduced cardiorespiratory fitness in older adults with HIV.
AIDS 38(6):825-833
Authors: Krisann K Oursler, Brandon C Briggs, Alicia J Lozano, Nadine M Harris, Amitabh Parashar, Alice S Ryan, Vincent C Marconi
Affiliations
- Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke.
- Geriatrics Extended Care, Salem Veterans Affairs Healthcare System, Salem, VA.
- Department of Health and Human Performance, Concordia University Chicago, Chicago, IL.
- Department of Statistics, Virginia Polytechnic Institute and State University, Roanoke, VA.
- Department of Medicine, Emory University School of Medicine, Atlanta.
- Infectious Diseases, VA Atlanta Healthcare System, Decatur, GA.
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.
- Baltimore Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center at the Veterans Affairs Maryland Healthcare System, Baltimore, MD.
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Abstract
OBJECTIVE
Understanding the physiological drivers of reduced cardiorespiratory fitness in people with HIV (PWH) will inform strategies to optimize healthspan. Chronotropic incompetence is common in heart failure and associated with low cardiorespiratory fitness yet is understudied in PWH. The objective was to determine the prevalence of chronotropic incompetence and its relationship with cardiorespiratory fitness.
DESIGN
Participants were PWH at least 50 years of age with no prior history of heart failure or coronary heart disease who were enrolled in a randomized exercise trial. Baseline cardiopulmonary exercise testing (CPET) was used to measure cardiorespiratory fitness as peak oxygen consumption (VO2peak) and calculate the chronotropic index from heart rate values. Chronotropic incompetence was defined as an index less than 80%.
RESULTS
The 74 participants were on average 61 years old, 80% Black or African American, and 93% men. Chronotropic incompetence was present in 31.1%. VO2peak was significantly lower among participants with chronotropic incompetence compared with participants without chronotropic incompetence [mean (SD) ml/min/kg: 20.9 (5.1) vs. 25.0 (4.5), P = 0.001]. Linear regression showed that chronotropic incompetence and age were independent predictors of VO2peak, but smoking and comorbidity were not. The chronotropic index correlated with VO2peak (r = 0.48, P < 0.001).
CONCLUSION
Among older PWH without heart failure or coronary heart disease, chronotropic incompetence was present in approximately one-third of individuals and was associated with clinically relevant impaired cardiorespiratory fitness. Investigation of chronotropic incompetence in large cohorts which includes PWH and heart failure may contribute to strategies that promote healthy aging with HIV infection and offer a preclinical window for intervention.
MeSH
Exercise, Heart Diseases, Heart Failure, Cardiorespiratory Fitness, Heart, Acquired Immunodeficiency Syndrome, Hiv, Coronary Disease