Why the study?
Heart rate trajectory is considered a more sensitive predictor than single measurements, but its association with acute heart failure outcomes has not been well studied.
Is a high-increasing-decreasing heart rate trajectory pattern associated with an increased risk of adverse outcomes in patients with acute heart failure?
Is a high-increasing-decreasing heart rate trajectory pattern associated with an increased risk of adverse outcomes in patients with acute heart failure?
A high-increasing-decreasing heart rate trajectory pattern is associated with a significantly higher risk of all-cause mortality in patients with acute heart failure compared to a low-stable pattern.
May identify higher-risk acute HF patients; leaves open whether trajectory monitoring refines management.
BACKGROUND: Heart rate trajectory with multiple heart rate measurements is considered to be a more sensitive predictor of outcomes than single heart rate measurements. The association of heart rate trajectory patterns with acute heart failure outcomes has not been well studied. We examined the association of heart rate trajectory patterns with post-discharge outcomes. METHODS: This prospective cohort study was based on an acute heart failure registry in Taiwan. A total of 1509 patients were enrolled in the Taiwan Society of Cardiology - Heart Failure with Reduced Ejection Fraction Registry from May 2013 to October 2015. The outcomes were post-discharge all-cause mortality and heart failure re-admission. RESULTS: Two heart trajectory patterns were identified in group-based trajectory analysis. One started with a higher heart rate and had an increasing trend over 6 months then a subsequent decline (high-increasing-decreasing group; n = 352; 23.9%). The other started with a lower heart rate and had a relatively stable pattern (low-stable group; n = 1121; 76.1%). Compared with those in the low-stable group, patients in the high-increasing-decreasing group had a higher risk of events (all-cause mortality: hazard ratio 3.10 and 95% confidence interval 1.24-7.77; heart failure re-admission: hazard ratio 1.13 and 95% confidence interval 0.55-2.32). CONCLUSIONS: Patients with a high-increasing-decreasing heart rate trajectory pattern had a higher risk of all-cause mortality than those with a low-stable pattern.
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Wei et al. (2020) studied this question.
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