The Effect of Heart Rate on Quality of Life in Patients with Chronic Heart Failure

Introduction . Chronic heart failure (CHF) leads to a steady deterioration in the quality of life (QOL) and a decrease in exercise tolerance of patients. Numerous studies have confirmed the role of increased heart rate in worsening the prognosis of CHF — heart rate more than 75 bpm needs reduction to optimize the clinical status of patients. The purpose of the study is to analyze the effect of heart rate on QOL and exercise tolerance in patients with CHF with a low left ventricular ejection fraction. Materials and methods . A prospective comparative study was conducted. 80 patients (54 men and 26 women, verage age — (66.3±7.9) years) with postinfarction cardiosclerosis and sinus rhythm, with CHF II–III NYHA functional classes with an ejection fraction less than 40 % were examined. Results . Significantly better QOL indicators were noted in patients with heart rate 60–69 bpm. The lowest indicators of functional activity were noted at 55–59 bpm, and socio-psychological activity at 70–75 bpm. Exercise tolerance is higher in patients with a heart rate of 60–69 bpm, its lowest rates were noted at 70–75 bpm. Discussion . The optimal heart rate range determination in patients with postinfarction cardiosclerosis and CHF allows targeted titration of the β-blocker dosage, achieving an improvement in QOL and the clinical and functional status of patients. Conclusion . In patients with CHF careful selection of β-blockers and ivabradine therapy demonstrates the most optimal indicators of physical activity and QOL with a heart rate of 60–64 bpm and 65–69 bpm.