Key result
Elevated resting heart rate is a modifiable risk factor in chronic heart failure that contributes to progressive mechanical dyssynchrony and reduced inotropy.
Elevated resting heart rate is a modifiable risk factor in chronic heart failure that contributes to myocardial dysfunction and whose management has been explored in recent trials.
Supports heart rate modulation in chronic HF; leaves open optimal targets and strategies.
Resting heart rate is a modifiable risk factor both in the general population and in patients with cardiovascular (CV) disease. Elevated heart rate is associated with reduced myocardial function in experimental settings and various pathophysiological mechanisms exist for the development of CV and myocardial dysfunction by tachycardia. In heart failure and systolic dysfunction, the myocardium is energetically starving. Elevated heart rate has then added negative consequences, including progressive mechanical dyssynchrony and reduced inotropy. The importance of heart rate in chronic heart failure (CHF) was recently explored in SHIFT (The Systolic Heart failure Treatment with the If inhibitor Ivabradine Trial).
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Swedberg et al. (2012) conducted a review in chronic heart failure. Ivabradine was evaluated. Elevated resting heart rate is a modifiable risk factor in chronic heart failure that contributes to progressive mechanical dyssynchrony and reduced inotropy.
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