Key result
A personalized target heart rate (THR) formula successfully discriminated the risk of all-cause death and ADHF readmission in patients with HFrEF, whereas a uniform 70 bpm cutoff did not.
Why the study?
The optimal heart rate in patients with HFrEF has been ill-defined, and the prognostic significance of a formula estimating target heart rate to eliminate E-A overlap needed validation.
Does achieving a personalized target heart rate (THR) reduce the composite of all-cause death and ADHF readmission in patients with HFrEF?
Cohort (n=647)
Yes
Does achieving a personalized target heart rate (THR) reduce the composite of all-cause death and ADHF readmission in patients with HFrEF?
A personalized target heart rate based on echocardiographic E-A overlap better predicts long-term outcomes in HFrEF patients than a uniform 70 bpm cutoff.
The optimal heart rate (HR) in patients with heart failure with reduced ejection fraction (HFrEF) has been ill-defined. Recently, a formula was proposed for estimating the target heart rate (THR), which eliminates the overlap between the E and A wave (E-A overlap). We aim to validate its prognostic significance in the multicenter WET-HF registry. This study used data from 647 patients with HFrEF hospitalized for acute decompensated HF (ADHF). The patients were divided into the 2 groups by THR. The primary endpoint was defined as the composite of all-cause death and ADHF readmission. The THR successfully discriminated the incidence of the primary endpoint, whereas no significant difference was observed in the primary endpoint when dividing the patients by uniform cutoff 70 bpm. HR at discharge ≤ THR was inversely associated with the primary endpoint. Restricted cubic spline analysis demonstrated the difference between HR at discharge, and THR (ΔHR) from -10 to ±0 was associated with a lower risk of primary endpoint and ΔHR from ±0 to +15 was associated with a higher risk. THR discriminated long-term outcomes in patients with HFrEF more efficiently than the uniform cutoff, suggesting that it may aid in tailored HR reduction strategies.
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Yumita et al. (2022) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) and acute decompensated HF (ADHF) (n=647). Personalized target heart rate (THR) vs. Uniform cutoff 70 bpm was evaluated on Composite of all-cause death and ADHF readmission. A personalized target heart rate (THR) formula successfully discriminated the risk of all-cause death and ADHF readmission in patients with HFrEF, whereas a uniform 70 bpm cutoff did not.
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