Heart Rate Recovery: Up to Date in Heart Failure-A Literature Review

Abstract

The rising prevalence of cardiovascular disease underscores the growing significance of heart failure (HF). Pathophysiological insights into HF highlight the dysregulation of the autonomic nervous system (ANS), characterized by sympathetic overactivity and diminished vagal tone, impacting cardiovascular function. Heart rate recovery (HRR), a metric measuring the heart's ability to return to its baseline rate post-exertion, plays a crucial role in assessing cardiovascular health. Widely applied across various cardiovascular conditions including HF, coronary artery disease (CAD), and arterial hypertension (HTN), HRR quantifies the difference between peak and recovery heart rates. Given its association with elevated sympathetic tone and exercise, HRR provides valuable insights into the perspective of HF, beyond effort tolerance, reaching toward prognostic and mortality indicators. Incorporating HRR into cardiovascular evaluations enhances our understanding of autonomic regulation in HF, offering potential implications for prognostication and patient management. This review addresses the significance of HRR in HF assessment, analyzing recently conducted studies, and providing a foundation for further research and clinical application.

Keywords: autonomic nervous system; cardiac exercise stress test; heart failure; heart rate recovery.

Figure 1

Graphical interpretation of heart rate recovery parameters. HRR1: HR MAX- HR1min (heart rate recovery at 1 min); HRR2: HR MAX-HR2 2 min (heart rate recovery at 2 min); HRRI: AT/DT (heart rate recovery index).