The impact of heart rate on patients diagnosed with heart failure with mid-range ejection fraction

Anatol J Cardiol. 2019 Feb;21(2):68-74. doi: 10.14744/AnatolJCardiol.2018.38364. Epub 2018 Dec 6.

Abstract

Objective: The relationship between prognosis and heart rate remains unclear among patients diagnosed with heart failure with mid-range ejection fraction (HFmrEF). The aim of the present study was to assess the effect of heart rate in this group of patients.

Methods: Of the 197 patients diagnosed with HFmrEF, 92 had a heart rate <70 beats/min (bpm), and 105 had a heart rate ≥70 bpm. We analyzed the outcomes including all-cause death and HF-related hospitalization and evaluated the quality of life.

Results: The outcome demonstrated a lower incidence in patients with heart rate <70 bpm. The outcome-free survival illustrated significant difference in survival rate (p=0.045). The Minnesota Living with Heart Failure Questionnaire total scores and physical subscale in the lower heart rate group decreased compared with the heart rate ≥70 bpm group (p=0.048 and p=0.03, respectively). In the following analysis of patients with sinus rhythm, beta blockers showed great positive effects on patients with heart rate <70 bpm (p=0.046), as for the quality of life in patients with beta blocker, heart rate <70 bpm showed lower total and physical scores (p=0.025 and p=0.017, respectively).

Conclusion: Our results showed that heart rate is an important prognostic factor in patients with HFmrEF. Patients with heart rate <70 bpm was related with a lower risk of outcomes and better quality of life. Beta blockers reduced the outcome rate in patients with sinus rhythm.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Female
  • Heart Failure / drug therapy
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Heart Failure / psychology
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Quality of Life
  • Stroke Volume*
  • Surveys and Questionnaires
  • Survival Analysis
  • Turkey

Substances

  • Adrenergic beta-Antagonists