Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
Med Sci Sports Exerc. 2012 Mar;44(3):371-6. doi: 10.1249/MSS.0b013e318234316f.
Standards for estimating maximal HR are important when interpreting the adequacy of physiologic stress during exercise testing, assessing chronotropic response, and prescribing an exercise training regimen. The equation 220 - age is used to estimate maximum HR; however, it overestimates measured maximal HR in patients taking β-adrenergic blockade (βB) therapy. This study developed and validated a practical equation to predict maximal HR in patients with heart failure (HF) taking βB therapy.
Data from symptom-limited exercise tests completed on patients with systolic HF participating in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training trial and taking a βB agent were used to develop a simplified equation, which was validated using bootstrapping.
The simplified derived equation was 119 + 0.5 (resting HR) - 0.5 (age) - (0, if test was completed using a treadmill; 5, if using a stationary bike). The R2 and SEE were 0.28 and 18 beats·min(-1), respectively. Validation of this equation yielded a mean R and SEE of 0.28 and 18 beats·min(-1), respectively. For the equation 220 - age, the R2 was -2.93, and the SEE was 43 beats·min(-1).
We report a valid and simple population-specific equation for estimating peak HR in patients with HF taking βB therapy. This equation should be helpful when evaluating chronotropic response or assessing if a maximum effort was provided during exercise testing. We caution, however, that the magnitude of the variation (SEE = 18 beats·min(-1)) associated with this prediction equation may make it impractical when prescribing exercise intensity.
在评估运动试验中生理应激的充分性、评估变时反应以及制定运动训练方案时，估计最大心率的标准非常重要。通常使用 220 - 年龄公式来估计最大心率；然而，β肾上腺素能阻滞剂（βB）治疗的患者中，该公式会高估实测的最大心率。本研究开发并验证了一种实用的公式，用于预测接受βB 治疗的心力衰竭（HF）患者的最大心率。
使用接受βB 治疗的收缩性 HF 患者进行的症状限制运动试验的数据来开发简化公式，并用自举法进行验证。
简化推导的公式为 119 + 0.5（静息心率）- 0.5（年龄）-（如果使用跑步机完成测试，则为 0；如果使用固定自行车，则为 5）。R2 和 SEE 分别为 0.28 和 18 次·min-1。该方程的验证得出的平均 R 和 SEE 分别为 0.28 和 18 次·min-1。对于 220 - 年龄公式，R2 为-2.93，SEE 为 43 次·min-1。
我们报告了一种针对接受βB 治疗的 HF 患者估计峰值 HR 的有效且简单的群体特异性公式。在评估变时反应或评估运动试验中是否达到最大努力时，该公式应该很有帮助。然而，我们提醒，与该预测方程相关的变化幅度（SEE = 18 次·min-1）可能使其在规定运动强度时不切实际。
