One-Minute Heart Rate Recovery and Clinical Outcomes in Transthyretin Cardiac Amyloidosis: Incremental Model Fit Beyond Conventional CPET Indices

Clicks: 7
ID: 333497
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #79 of 80 articles by views in European Heart Journal Open

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Aims To assess the association of one-minute heart rate recovery (HRR1) with clinical outcomes and its incremental contribution to model fit beyond peak VO2 and ventilatory efficiency (VE/VCO2 slope) in transthyretin cardiac amyloidosis (ATTR-CM). Methods Consecutive adults with confirmed ATTR-CM undergoing symptom-limited cardiopulmonary exercise testing (CPET) were included in this single-centre observational study. During standardised active recovery at 24 W, HRR1 was defined as peak heart rate minus heart rate exactly 60 seconds after exercise. Cox proportional-hazards models evaluated all-cause mortality and the composite of mortality or first heart-failure hospitalisation. Principal models adjusted for age, sex, peak VO2 and VE/VCO2 slope; NT-proBNP and National Amyloidosis Centre (NAC) stage were examined separately. Results Of 161 baseline patients, 11 with unverifiable heart-rate measurements were excluded, and exact HRR1 was available in 110. Mortality analysis included 105 patients with 33 deaths; composite-outcome analysis included 107 patients with 51 events. Median HRR1 was 15.5 bpm. In conventional CPET-adjusted models, each 10-bpm greater HRR1 was associated with lower hazards of mortality (hazard ratio [HR] 0.65, 95% confidence interval [CI] 0.44–0.95; P = 0.028) and the composite outcome (HR 0.74, 95% CI 0.57–0.97; P = 0.029). Adding HRR1 improved model fit (likelihood-ratio P = 0.017 and P = 0.021, respectively); apparent C-indices increased from 0.770 to 0.795 for mortality and from 0.695 to 0.699 for the composite outcome. Associations were non-significant after separate adjustment for NT-proBNP or NAC stage. Conclusion HRR1 remained associated with outcomes after CPET adjustment and improved model fit. Discrimination gains were modest; value beyond biomarker staging was unproven.
Reference Key
openalex_W7223248397 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Antonio Kösters, Nikita Ermolaev, Mahshid Eslami, L Lichtblau, Lisa Seilinger, Stefanie Pahr, Mariusz Tadeusz Grzeda, Roza Badr Eslam
Are you one of these authors? Claim your profile
Journal European Heart Journal Open
Year 2026
DOI
10.1093/ehjopen/oeag181
URL
https://doi.org/10.1093/ehjopen/oeag181
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.