Background:The aim of this study was to investigate the association of inflammatory marker and echoparameters with impaired chronotropic response during treadmill exercise test.Methods:We enrolled 151 patients who underwent treadmill exercise test.Conventional echocardiography with tissue Doppler imaging(TVI)of mitral annulus motion was conducted in the simultaneous day.TVI was performed at the septal side of the mitral annulus,using apical 4 chamber view.Serum for the level of CRP was obtained for the inflammatory activity.Chronotropic incompetence(CI)was defined as failure to achieve 85% of the age predicted maximum heart rate.Results:Of the 151 patients with no evidence of coronary artery diseases,36 (24%) exhibited CI.The patients with CI showed lower TVI of mitral annulus systolic velocity (E���),higher mitral inflow to early diastolic tissue velocity ratio (E/E���) and CRP level. Simple linear regression analysis showed that the chronotropic response was negatively correlated with the value of CRP(r=-0.240,p=0.003) and E/E���ratio(r=-0.221,p=0.006).By multivariate analysis,impaired chronotropic responses were significantly associated with the increased E/E���ratio and CRP level.In addition,the patients with increased E/E���ratio were more often older and more likely to have a low METs(metabolic equivalents of oxygen consumption) with impaired chronotropic response.Conclusion:Impaired chronotropic response with the subtle change of inflammatory marker or echocardiographic parameters may contribute to the increased risk of cardiovascular disease.