Heart Rate Recovery as a Preoperative Test of Perioperative Complication Risk

Abstract

The autonomic nervous system plays important physiologic roles in a variety of organ systems. Autonomic dysfunction has been shown to be predictive of increased mortality in patients with cardiovascular disease. Its importance in patients with chronic respiratory disorders has been described in recent years. Here, we summarize the prognostic value of autonomic dysfunction, as reflected by impaired heart rate recovery (HRR), in patients with chronic respiratory disorders, including chronic obstructive pulmonary disease, interstitial lung disease, and lung cancer. We suggest that HRR may be clinically useful in the preoperative physiologic evaluation, specifically in lung cancer patients being considered for surgery.

Fig 1.

Potential addition of HRR to the physiologic evaluation of lung cancer patients worthy of further study. (CPET = cardiopulmonary exercise testing; HRR = heart rate recovery; ppoDL_CO = predicted postoperative DL_CO; ppoFEV₁ = predicted postoperative FEV₁; SCT = stair climbing test; SWT = shuttle walk test; VO_2max = maximal oxygen consumption; 6MWT = 6-min walk test.)