Rose Mary Ferreira Lisboa da Silva1, Anaisa Silva Roever Borges2, Nilson Penha Silva3, Elmiro Santos Resende3, Gary Tse4,5, Tong Liu6, Leonardo Roever3, Giuseppe Biondi-Zoccai7,8. 1. Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. roselisboa@uol.com.br. 2. Master Institute of Education President Antonio Carlos, IMEPAC, Araguari, Brazil. 3. Department of Clinical Research, Federal University of Uberlandia, Uberlândia, Brazil. 4. Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China. 5. Faculty of Medicine, Li KaShing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China. 6. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, China. 7. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. 8. Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.
Abstract
PURPOSE OF REVIEW: Resting heart rate is an independent risk factor for all-cause and cardiovascular mortality in patients with heart failure. The main objectives are to discuss the prognosis of heart rate, its association with coronary atherosclerosis, and the modalities of control of the heart rate in sinus rhythm and in the rhythm of atrial fibrillation in patients with chronic heart failure. RECENT FINDINGS: As a therapeutic option for control heart rate, medications such as beta-blockers, digoxin, and finally ivabradine have been studied. Non-dihydropyridine calcium channel blockers are contraindicated in patients with heart failure and reduced ejection fraction. The influence of the magnitude of heart rate reduction and beta-blocker dose on morbidity and mortality will be discussed. Regarding the patients with heart failure and atrial fibrillation, there are different findings in heart rate control with the use of a beta-blocker. Patients eligible for ivabradine have clinical benefits and increased ejection fraction. Vagal nerve stimulation has low efficacy for the control of heart rate. Complementary therapies such as tai chi and yoga showed no effect on heart rate. In this review, we discuss the main therapeutic options for the control of heart rate in patients with atherosclerosis and heart failure. More research is needed to examine the effects of therapeutic options for heart rate control in different population types, as well as their effects on clinical outcomes and impact on morbidity and mortality.
PURPOSE OF REVIEW: Resting heart rate is an independent risk factor for all-cause and cardiovascular mortality in patients with heart failure. The main objectives are to discuss the prognosis of heart rate, its association with coronary atherosclerosis, and the modalities of control of the heart rate in sinus rhythm and in the rhythm of atrial fibrillation in patients with chronic heart failure. RECENT FINDINGS: As a therapeutic option for control heart rate, medications such as beta-blockers, digoxin, and finally ivabradine have been studied. Non-dihydropyridine calcium channel blockers are contraindicated in patients with heart failure and reduced ejection fraction. The influence of the magnitude of heart rate reduction and beta-blocker dose on morbidity and mortality will be discussed. Regarding the patients with heart failure and atrial fibrillation, there are different findings in heart rate control with the use of a beta-blocker. Patients eligible for ivabradine have clinical benefits and increased ejection fraction. Vagal nerve stimulation has low efficacy for the control of heart rate. Complementary therapies such as tai chi and yoga showed no effect on heart rate. In this review, we discuss the main therapeutic options for the control of heart rate in patients with atherosclerosis and heart failure. More research is needed to examine the effects of therapeutic options for heart rate control in different population types, as well as their effects on clinical outcomes and impact on morbidity and mortality.
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Authors: Anh L Bui; Maria V Grau-Sepulveda; Adrian F Hernandez; Eric D Peterson; Clyde W Yancy; Deepak L Bhatt; Gregg C Fonarow Journal: Am Heart J Date: 2013-02-16 Impact factor: 4.749
Authors: John G F Cleland; Karina V Bunting; Marcus D Flather; Douglas G Altman; Jane Holmes; Andrew J S Coats; Luis Manzano; John J V McMurray; Frank Ruschitzka; Dirk J van Veldhuisen; Thomas G von Lueder; Michael Böhm; Bert Andersson; John Kjekshus; Milton Packer; Alan S Rigby; Giuseppe Rosano; Hans Wedel; Åke Hjalmarson; John Wikstrand; Dipak Kotecha Journal: Eur Heart J Date: 2018-01-01 Impact factor: 29.983