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Our group has experience with chronotropic incompetence (CI) by using physical stress echocardiography as the diagnostic method; according to already performed cohorts, CI has shown prognostic value. That is the preferred method for individuals with preserved physical capacity.
Despite the well-known clinical implications, the underlying mechanism of CI has not been well clarified, autonomic dysfunction being the most frequently found hypothesis in the studies. The use of dobutamine is known to involve an autonomic system participant, the myocardial beta 1 adrenergic receptor, and is more restrictive than physical effort, which involves all the complexity of the system.
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