{
  "abstract": "Aims: To assess the association of 1-min 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).\n\nMethods and results: Consecutive adults with confirmed ATTR-CM undergoing symptom-limited cardiopulmonary exercise testing (CPET) were included in this single-centre observational study. During standardized active recovery at 24 W, HRR1 was defined as peak heart rate minus heart rate exactly 60 s after exercise. Cox proportional-hazards models evaluated all-cause mortality and the composite of mortality or first heart-failure hospitalization. Principal models adjusted for age, sex, peak VO2 and VE/VCO2 slope; NT-proBNP and National Amyloidosis Centre (NAC) stage were examined separately. 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.\n\nConclusion: HRR1 remained associated with outcomes after CPET adjustment and improved model fit. Discrimination gains were modest; value beyond biomarker staging was unproven.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Antonio Kösters",
      "orcid": "0009-0001-5837-5708"
    },
    {
      "name": "Nikita Ermolaev"
    },
    {
      "name": "Mahshid Eslami",
      "orcid": "0009-0003-7401-2135"
    },
    {
      "name": "Leonhard Lichtblau"
    },
    {
      "name": "Lisa Seilinger"
    },
    {
      "name": "Stefanie Pahr"
    },
    {
      "name": "Mariusz Grzeda"
    },
    {
      "name": "Roza Badr Eslam",
      "orcid": "0000-0002-0360-2360"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/85xb8wv6p2gnq.bib",
  "cited_by": 0,
  "doi": "10.1093/ehjopen/oeag181",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13728343/?tool=EBI",
  "id": "85xb8wv6p2gnq",
  "issns": [
    "2752-4191"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13728343",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00200"
    ],
    [
      "heading",
      "Eurheartj/12"
    ],
    [
      "heading",
      "Eurheartj/27"
    ],
    [
      "heading",
      "Eurheartj/29"
    ],
    [
      "heading",
      "Eurheartj/45"
    ],
    [
      "heading",
      "Eurheartj/47"
    ],
    [
      "heading",
      "Heart Failure"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2724|Amyloidosis: Diagnosis, Treatment, Outcomes"
    ]
  ],
  "openalex": "W7223248397",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13728343/pdf/?tool=EBI",
  "pmcid": "PMC13728343",
  "pmid": "42979091",
  "published": "2026-10-22",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/85xb8wv6p2gnq.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "PMC:PMC13728343",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13728343"
    },
    {
      "first_seen": "2026-11-07T12:21:21Z",
      "native_id": "PMC13728343",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ehjopen/oeag181"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "One-minute heart rate recovery and clinical outcomes in transthyretin cardiac amyloidosis: incremental model fit beyond conventional CPET indices",
  "title_text": "One-minute heart rate recovery and clinical outcomes in transthyretin cardiac amyloidosis: incremental model fit beyond conventional CPET indices",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:21Z",
  "url": "https://research.draconitic.com/paper/85xb8wv6p2gnq",
  "venue": "European heart journal open",
  "versions": []
}