Lower heart rate in patients with acute heart failure : the role of left ventricular ejection fraction
Lorenzo, M. (Instituto de Investivación Sanitaria INCLIVA)
Miñana, G. (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Palau, P. (Universitat de València)
Núñez, G. (Instituto de Investivación Sanitaria INCLIVA)
de la Espriella, R. (Instituto de Investivación Sanitaria INCLIVA)
Santas, E. (Universitat de València)
Villar, S. (Instituto de Investivación Sanitaria INCLIVA)
Donoso, V. (Hospital Universitari i Politècnic La Fe (València))
Núñez, E. (Instituto de Investivación Sanitaria INCLIVA)
Sanchis, J. (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Núñez, J. (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Background: The clinical impact of heart rate (HR) in heart failure with preserved ejection fraction (HFpEF) is a matter of debate. Among those with HFpEF, chronotropic incompetence (CI) has emerged as a pathophysiological mechanism linked to the severity of the disease. In this study, we sought to evaluate whether admission heart rate in acute heart failure differs along left ventricular ejection fraction (LVEF). Methods: We included retrospectively 3,712 consecutive patients admitted for acute heart failure (AHF) in the Cardiology department of a third level center. HR values were assessed at presentation. LVEF was assessed by transthoracic echocardiogram during the index admission and stratified into four categories: reduced ejection fraction ((Formula presented. ) 40%), mildly reduced ejection fraction (41-49%), preserved ejection fraction (50-64%) and supranormal ejection fraction ((Formula presented. ) 65%). The association between HR and LVEF was assessed by multivariate linear and multinomial regression analyses. Results: The mean age of the sample was 73,9 ± 11. 3 years, 1,734 (47,4%) were women, and 1,214 (33,2%), 570 (15,6%), 1,229 (33,6%) and 648 (17,7%) patients showed LVEF (Formula presented. ) 40%, 41-49%, 50-64%, and ≥65% respectively. The median HR at admission was 95 (IQR 78-120) beats per minute and 1,653 were on atrial fibrillation (45. 2%). There was an inverse relationship between HR at admission and LVEF. Lower HR was significantly associated with a higher LVEF in the whole sample (p < 0,001). This inverse relationship was found in sinus rhythm but not in patients with atrial fibrillation. Conclusion: HR at admission for AHF is a predictor of LVEF but only in patients with sinus rhythm.
Grants:	Instituto de Salud Carlos III PI20/00392
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Heart rate ; Acute heart failure ; Chronotropic incompetence ; Heart failure with preserved ejection fraction ; Supranormal left ventricular ejection fraction
Published in:	Scandinavian Cardiovascular Journal, Vol. 58 Núm. 1 (2024) , p. 2386977, ISSN 1651-2006

DOI: 10.1080/14017431.2024.2386977
PMID: 39115187

9 p, 1.7 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles