Key result
In patients with heart failure with reduced ejection fraction, a resting heart rate >72 bpm was associated with a higher risk of adverse outcomes in those with sinus rhythm (p=0.033), but this relationship was not evident in patients with atrial fibrillation.
Why the study?
Higher resting heart rate is linked to lower exercise capacity and worse prognosis in HF, but recent studies question this relationship in HF patients in AF.
Does the relationship between resting heart rate, functional capacity, and prognosis differ between HFrEF patients in atrial fibrillation versus sinus rhythm?
Cohort (n=282)
No
Does the relationship between resting heart rate, functional capacity, and prognosis differ between HFrEF patients in atrial fibrillation versus sinus rhythm?
p-value: p=0.033
The impact of resting heart rate on exercise capacity and prognosis differs entirely between atrial fibrillation and sinus rhythm in HFrEF patients, suggesting heart rate control should be managed differently based on rhythm.
Should not yet alter heart rate targets by rhythm in HFrEF; leaves open need for prospective validation of differential prognostic impact.
Background: Higher resting heart rate (HR) is associated with lower exercise capacity and worse prognosis in patients with heart failure (HF). However, recent studies question this relationship in HF patients in atrial fibrillation (AF). We aimed to examine and compare the relationships between resting HR, exercise capacity and outcomes in HF patients in AF and sinus rhythm (SR).
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Moreira et al. (2019) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=282). Resting heart rate >72 bpm vs. Resting heart rate ≤72 bpm was evaluated on Composite of cardiac death, unplanned heart transplant, or need for mechanical circulatory support (p=0.033). In patients with heart failure with reduced ejection fraction, a resting heart rate >72 bpm was associated with a higher risk of adverse outcomes in those with sinus rhythm (p=0.033), but this relationship was not evident in patients with atrial fibrillation.
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