{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:34:57Z","timestamp":1789223697753,"version":"build-2803163510"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:sec id=\"jah310899-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Cardiac autonomic dysfunction is associated with heart failure (HF). Reduced heart rate recovery (HRR) indicates impaired parasympathetic reactivation after physical activity. Heart rate recovery 60 seconds after peak effort (HRR\n              <jats:sub>60<\/jats:sub>\n              ) is linked to autonomic dysfunction, but data on its relevance across HF phenotypes are scarce. This study aimed to identify clinical determinants of HRR\n              <jats:sub>60<\/jats:sub>\n              in an HF cohort and assess its relationship with clinical outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310899-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Data from the MyoVasc study (NCT04064450; N=3289) were analyzed. Participants underwent standardized clinical phenotyping including cardiopulmonary exercise testing. HRR\n              <jats:sub>60<\/jats:sub>\n              was defined as the heart rate decline 60\u2009seconds after exercise termination. Clinical determinants of HRR\n              <jats:sub>60<\/jats:sub>\n              were evaluated using multivariate regression, whereas Cox regression analyses assessed all\u2010cause death and worsening of HF.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310899-sec-0003\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The analysis sample comprised 1289 individuals (median age, 66.0 [interquartile range {IQR}, 58.0\u201373.0] years, 30.4% women) ranging from stage B to stage C\/D according to the universal definition of HF. Age, sex, smoking, obesity, peripheral artery disease, and chronic kidney disease were identified as determinants of HRR\n              <jats:sub>60<\/jats:sub>\n              . HRR\n              <jats:sub>60<\/jats:sub>\n              showed a strong association with all\u2010cause death (hazard ratio [HR]\n              <jats:sub>HRR60 [10 bpm]<\/jats:sub>\n              , 1.56 [95% CI, 1.32\u20131.85];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.0001) and worsening of HF (HR\n              <jats:sub>HRR60 [10 bpm]<\/jats:sub>\n              , 1.36 [95% CI, 1.10\u20131.69];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.0052) independent of age, sex, and clinical profile. Sensitivity analysis showed a stronger association with worsening HF in HF with preserved left ventricular ejection fraction (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.027).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310899-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              HRR\n              <jats:sub>60<\/jats:sub>\n              was associated with clinical outcome in chronic HF. Because it showed a stronger association with outcomes in HF with preserved ejection fraction, future research should consider phenotype\u2010specific differences.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039792","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T09:38:32Z","timestamp":1747301912000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Role of Heart Rate Recovery in Chronic Heart Failure: Results From the MyoVasc\u00a0Study"],"prefix":"10.1161","volume":"14","author":[{"given":"David","family":"Velmeden","sequence":"first","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]},{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"S\u00f6hne","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]},{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schuch","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]},{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silav","family":"Zeid","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulz","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4570-2025","authenticated-orcid":false,"given":"Sven\u2010Oliver","family":"Troebs","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]},{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0134-2726","authenticated-orcid":false,"given":"Marc W.","family":"Heidorn","sequence":"additional","affiliation":[{"name":"University Medical Center of the Johannes Gutenberg University Mainz","place":["Mainz, Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine\u2010Main","place":["Mainz, Germany"]},{"name":"University Medical Center of the Johannes 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