Atrial fibrillation (AF) and heart failure (HF): Effect on exercise tolerance

Changes in the severity of heart failure in patients with toxic goiter after surgery are insufficiently studied.The objective of the research was to study changes in cardiac disorders in the remote period after surgical treatment of toxic goiter.Material and methods. The study included 48 patients with toxic goiter and moderate thyrotoxicosis and 102 patients with severe thyrotoxicosis. Cardiac disorders and changes in cardiac function after surgery were studied using the following gradation: good, satisfactory, unsatisfactory results and ineffective treatment.Results. Good and satisfactory results of surgical treatment in patients with moderate thyrotoxicosis were obtained in 47 (98%) cases and in patients with severe thyrotoxicosis they were achieved in 45 (44%) cases. Unsatisfactory outcome was determined by the severity of thyrotoxicosis, its duration, and low exercise tolerance during the 6-min walking test.Conclusions. Persistent severe thyrotoxicosis leads to atrial fibrillation and heart failure, which in most cases (66%) after surgical treatment of toxic goiter do not undergo reversible changes.

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Heart rate recovery is useful for evaluating the recovery of exercise tolerance in patients with heart failure and atrial fibrillation

Heart and Vessels ◽

10.1007/s00380-021-01839-6 ◽

2021 ◽

Author(s):

Seiya Tanaka ◽

Taro Miyamoto ◽

Yusuke Mori ◽

Takashi Harada ◽

Hiromi Tasaki

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Heart Rate ◽

Regression Analysis ◽

Linear Regression ◽

Cardiac Rehabilitation ◽

Exercise Tolerance ◽

Heart Rate Recovery ◽

Linear Regression Analysis ◽

Patients With Heart Failure

AbstractThis study aimed to examine the factors that contribute to improvement of exercise tolerance in patients with heart failure (HF) and atrial fibrillation (AF) following cardiac rehabilitation. Our hypothesis is that parasympathetic values are important for recovering exercise tolerance in those patients. We included 84 consecutive patients with HF and AF (mean age: 69 ± 15 years, 80% men). All of the patients underwent a cardiopulmonary exercise test and had pre and post 5 month cardiac rehabilitation assessed. After 155 ± 11 days and 44 ± 8 sessions, 73 patients (86%) showed an increase in peak oxygen uptake (VO2) and VO2 at the anaerobic threshold. In univariate linear regression analysis, the % change in heart rate recovery, plasma B-type natriuretic peptide levels, resting heart rate, and the minute ventilation /carbon dioxide output slope were significantly related to that of peak VO2 (p < 0.01, p = 0.03, p = 0.02, p < 0.01, respectively). Stepwise multivariate linear regression analysis showed that the % change in heart rate recovery was independently related to that of peak VO2 (p < 0.05). Our results suggest that heart rate recovery is closely associated with recovery of exercise tolerance in patients with HF and AF after CR.

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