Patrizio Lancellotti1, Arnaud Ancion2, Julien Magne2, Giovanni Ferro2, Luc A Piérard2. 1. University Hospital of Liège, GIGA Cardiovascular Sciences, Acute Care Unit, Heart Failure Clinic, CHU Sart Tilman, Liège, Belgium. Electronic address: plancellotti@chu.ulg.ac.be. 2. University Hospital of Liège, GIGA Cardiovascular Sciences, Acute Care Unit, Heart Failure Clinic, CHU Sart Tilman, Liège, Belgium.
Abstract
BACKGROUND: Elevated resting heart rate is associated with worse outcomes in chronic heart failure (HF) but little is known about its prognostic impact in acute setting. The main aim of the present study was to examine the relationship between resting heart rate obtained 24-36h after admission for acute non-arrhythmic HF and in-hospital mortality. METHODS AND RESULTS: We examined the association of heart rate with in-hospital mortality in a cohort of 712 patients admitted for acute HF. None of the patients had significant arrhythmias, required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Forty patients (5.6%) died during the hospital stay. Those patients were significantly older (78±9 vs. 72±12years; p=0.0021), had higher heart rate (92±22 vs. 78±18bpm; p<0.0001), NT pro-BNP (p=0.0005), creatinine (p=0.023), were often diabetics (p=0.026) and had lower systolic and diastolic blood pressures (p<0.05). There was a significant graded relationship between the increase in mortality rate and tertile of heart rate (p<0.01). With multivariable analysis, age (p=0.037), heart rate (p<0.0001), diastolic blood pressure (p<0.001), prior ischemic heart disease (p=0.02) and creatinine (p=0.019) emerged as independent predictors of in-hospital mortality. After adjusting for predictors of poor prognosis, patients in the highest heart rate tertile had worst outcomes when compared with those in the lowest heart rate group (p=0.007). CONCLUSIONS: Higher heart rate 24-36h after admission for acute non-arrhythmic HF is associated with increased risk of in-hospital mortality. Early targeting of elevated heart rate might represent a complementary therapeutic challenge.
BACKGROUND: Elevated resting heart rate is associated with worse outcomes in chronic heart failure (HF) but little is known about its prognostic impact in acute setting. The main aim of the present study was to examine the relationship between resting heart rate obtained 24-36h after admission for acute non-arrhythmic HF and in-hospital mortality. METHODS AND RESULTS: We examined the association of heart rate with in-hospital mortality in a cohort of 712 patients admitted for acute HF. None of the patients had significant arrhythmias, required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Forty patients (5.6%) died during the hospital stay. Those patients were significantly older (78±9 vs. 72±12years; p=0.0021), had higher heart rate (92±22 vs. 78±18bpm; p<0.0001), NT pro-BNP (p=0.0005), creatinine (p=0.023), were often diabetics (p=0.026) and had lower systolic and diastolic blood pressures (p<0.05). There was a significant graded relationship between the increase in mortality rate and tertile of heart rate (p<0.01). With multivariable analysis, age (p=0.037), heart rate (p<0.0001), diastolic blood pressure (p<0.001), prior ischemic heart disease (p=0.02) and creatinine (p=0.019) emerged as independent predictors of in-hospital mortality. After adjusting for predictors of poor prognosis, patients in the highest heart rate tertile had worst outcomes when compared with those in the lowest heart rate group (p=0.007). CONCLUSIONS: Higher heart rate 24-36h after admission for acute non-arrhythmic HF is associated with increased risk of in-hospital mortality. Early targeting of elevated heart rate might represent a complementary therapeutic challenge.
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: Renata R T Castro; Luka Lechnewski; Alan Homero; Denilson Campos de Albuquerque; Luis Eduardo Rohde; Dirceu Almeida; João David; Salvador Rassi; Fernando Bacal; Edimar Bocchi; Lidia Moura Journal: Arq Bras Cardiol Date: 2021-01 Impact factor: 2.000