BACKGROUND: Elevated resting heart rates have been associated with increased mortality and morbidity in patients with heart failure and decreased left ventricular ejection fraction (EF). It is unclear, though, if this association applies to those with heart failure and preserved EF. METHODS AND RESULTS: We determined outcome for 685 consecutive patients with a prior diagnosis of heart failure and a preserved EF (>50%) documented on echocardiography at 1 of 3 laboratories. Patients with non-sinus rhythm were excluded from the analysis. We determined adjusted mortality rates at 1 year after the echocardiogram. The mean age of the cohort was 70 ± 11 years. Of the 685 included patients, 87% had a history of hypertension, 50% had diabetes, and the mean EF was 60% ± 6%. All-cause mortality at 1 year was significantly lower in the group with heart rate below 60 beats/min (10%) when compared with the group with heart rates between 60 and 70 beats/min (18%), 71-90 beats/min (20%), and >90 beats/min (35%) (P < .0001). After adjustment for patient history, demographics, laboratory values, and echocardiographic findings, the hazard ratios for total mortality (relative to a heart rate of <60) were 1.26 (95% CI, 0.88-1.80) for HR 60-69, 1.47 (95% CI, 1.02-2.07) for HR 70-90, and 2.00 (95% CI, 1.31-3.04) for HR>90 (P = .01 across all groups). CONCLUSIONS: These data suggest that an elevated resting heart rate is a marker for increased mortality in patients with heart failure and preserved systolic function. Heart rate may be useful in these patients for improved cardiovascular risk assessment.
BACKGROUND: Elevated resting heart rates have been associated with increased mortality and morbidity in patients with heart failure and decreased left ventricular ejection fraction (EF). It is unclear, though, if this association applies to those with heart failure and preserved EF. METHODS AND RESULTS: We determined outcome for 685 consecutive patients with a prior diagnosis of heart failure and a preserved EF (>50%) documented on echocardiography at 1 of 3 laboratories. Patients with non-sinus rhythm were excluded from the analysis. We determined adjusted mortality rates at 1 year after the echocardiogram. The mean age of the cohort was 70 ± 11 years. Of the 685 included patients, 87% had a history of hypertension, 50% had diabetes, and the mean EF was 60% ± 6%. All-cause mortality at 1 year was significantly lower in the group with heart rate below 60 beats/min (10%) when compared with the group with heart rates between 60 and 70 beats/min (18%), 71-90 beats/min (20%), and >90 beats/min (35%) (P < .0001). After adjustment for patient history, demographics, laboratory values, and echocardiographic findings, the hazard ratios for total mortality (relative to a heart rate of <60) were 1.26 (95% CI, 0.88-1.80) for HR 60-69, 1.47 (95% CI, 1.02-2.07) for HR 70-90, and 2.00 (95% CI, 1.31-3.04) for HR>90 (P = .01 across all groups). CONCLUSIONS: These data suggest that an elevated resting heart rate is a marker for increased mortality in patients with heart failure and preserved systolic function. Heart rate may be useful in these patients for improved cardiovascular risk assessment.
Authors: Paweł Balsam; Michał Peller; Sonia Borodzicz; Agnieszka Kapłon-Cieślicka; Krzysztof Ozierański; Agata Tymińska; Michał Marchel; Maria G Crespo-Leiro; Aldo Pietro Maggioni; Jarosław Drożdż; Marcin Grabowski; Krzysztof J Filipiak; Grzegorz Opolski Journal: Cardiol J Date: 2018-08-29 Impact factor: 2.737
Authors: Warren K Laskey; Ihab Alomari; Margueritte Cox; Phillip J Schulte; Xin Zhao; Adrian F Hernandez; Paul A Heidenreich; Zubin J Eapen; Clyde Yancy; Deepak L Bhatt; Gregg C Fonarow Journal: J Am Heart Assoc Date: 2015-04-22 Impact factor: 5.501
Authors: Phillip H Lam; Daniel J Dooley; Prakash Deedwania; Steven N Singh; Deepak L Bhatt; Charity J Morgan; Javed Butler; Selma F Mohammed; Wen-Chih Wu; Gurusher Panjrath; Michael R Zile; Michel White; Cherinne Arundel; Thomas E Love; Marc R Blackman; Richard M Allman; Wilbert S Aronow; Stefan D Anker; Gregg C Fonarow; Ali Ahmed Journal: J Am Coll Cardiol Date: 2017-10-10 Impact factor: 24.094
Authors: Yunchan Chen; Emmanuel Alphonce; Eva Mujuni; Godfrey A Kisigo; Justin R Kingery; Abel Makubi; R N Peck; Fredrick Kalokola Journal: BMJ Open Date: 2022-01-19 Impact factor: 2.692