Increased Heart Rate during Walk Test Predicts Chronic-Phase Worsening of Renal Function in Patients with Acute Myocardial Infarction and Normal Kidney Function

Asami Ogura, Kazuhiro P. Izawa, Hideto Tawa, Fumie Kureha, Masaaki Wada, Masashi Kanai, Ikko Kubo, Ryohei Yoshikawa and Yuichi Matsuda
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Asami Ogura: Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
Kazuhiro P. Izawa: Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
Hideto Tawa: Department of Cardiology, Sanda City Hospital, Sanda 669-1311, Japan
Fumie Kureha: Department of Cardiology, Sanda City Hospital, Sanda 669-1311, Japan
Masaaki Wada: Department of Rehabilitation, Sanda City Hospital, Sanda 669-1311, Japan
Masashi Kanai: Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
Ikko Kubo: Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
Ryohei Yoshikawa: Department of Cardiology, Sanda City Hospital, Sanda 669-1311, Japan
Yuichi Matsuda: Department of Cardiology, Sanda City Hospital, Sanda 669-1311, Japan

IJERPH, 2019, vol. 16, issue 23, 1-10

Abstract: Chronic-phase worsening renal function (WRF) in patients with acute myocardial infarction (AMI) has been associated with poor prognosis. However, there is no consensus on either the method of prevention or the cause. The aim of this study was to determine factors predictive of chronic-phase WRF from the viewpoint of circulatory dynamics response to exercise during hospitalization of AMI patients without renal dysfunction on admission. We studied 186 consecutively AMI patients who underwent the 200-m walk test. Chronic-phase WRF was defined as a 20% decrease in estimated glomerular filtration rate (eGFR) from baseline to 8–10 months after AMI onset. Heart rate (HR) and systolic blood pressure recorded during the 200-m walk test were evaluated as circulatory dynamics responses. In total, 94 patients were enrolled. Multiple linear regression analysis showed that ΔHR (peak-rest) associated significantly with ΔeGFR ( β = 0.427, p = 0.018). The receiver operating characteristic curve of ΔHR to predict chronic-phase WRF showed an area under the curve of 0.77, with a cut-off value of 22.0 bpm having a 95% sensitivity and 55% specificity. Among circulatory dynamics responses during exercise in the acute phase after AMI, ΔHR was an independent predictor of chronic-phase WRF.

Keywords: acute myocardial infarction; worsening renal function; walk test; heart rate (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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