Association between resting heart rate, chronotropic index, and long-term outcomes in patients with heart failure receiving β-blocker therapy: data from the HF-ACTION trial
Key result
Each 0.1 unit decrease in chronotropic index <0.6 was associated with a 17% increased risk of all-cause mortality (HR 1.17; 95% CI 1.01-1.36; P=0.036) in HF patients on beta-blockers.
Why the study?
Is chronotropic index associated with clinical outcomes in patients with HFrEF on optimal β-blocker therapy?
Population
1118 patients with heart failure and reduced ejection fraction in sinus rhythm receiving β-blocker therapy…
Design
Cohort
Follow-up
median 32 months
Authors
Discussion
Loading...
Member takes
Implication
May aid risk stratification in beta-blocked HFrEF; hypothesis-generating for CI-targeted interventions.
Study Design
Type
Observational (n=1,118)
Structured PICO
Is chronotropic index associated with clinical outcomes in patients with HFrEF on optimal β-blocker therapy?
P
Population
1118 patients with heart failure and reduced ejection fraction (EF < 35%) in sinus rhythm receiving β-blocker therapy who performed with maximal effort on an exercise test (data from the HF-ACTION trial)
I
Intervention
Chronotropic index (CI) and resting heart rate (HR) assessment
O
Outcome
Composite of all-cause mortality or hospitalizationcomposite
In HFrEF patients on optimal beta-blocker therapy, an impaired chronotropic response to exercise (CI <0.6) is associated with increased mortality and heart failure hospitalization.
Cite This Study
Dobre et al. (2013) conducted an observational in chronic heart failure with reduced ejection fraction (EF < 35%) (n=1,118). Chronotropic index (CI) and resting heart rate (HR) was evaluated on all-cause mortality or hospitalization. Each 0.1 unit decrease in chronotropic index <0.6 was associated with a 17% increased risk of all-cause mortality (HR 1.17; 95% CI 1.01-1.36; P=0.036) in HF patients on beta-blockers.