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Heart rate control and its predictors in patients with heart failure and sinus rhythm. Data from the European Society of Cardiology Long-Term Registry
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Affiliations- 1st Department of Cardiology, Medical University of Warsaw, Poland
- Complexo Hospitalario Universitario A Coruña (CHUAC)-CIBERCV, La Coruña, Spain
- Centro Studi ANMCO (Associazione Nazionale Medici Cardiologi Ospedalieri), Florence, Italy
- Department of Cardiology, 1st Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland
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Abstract
Background: Higher resting heart rate (HR) in patients with heart failure (HF) and sinus rhythm (SR) is associated with increased mortality. In patients hospitalized for HF, the aim herein, was to assess the use and dosage of guideline-recommended HR lowering medications, HR control at discharge and predictors of HR control. Methods: In the present study, were Polish participants of the European Society of Cardiology HF Long-Term (ESC-HF-LT) Registry. Those selected were hospitalized for HF, with reduced ejection fraction (HFrEF) and SR at discharge (n = 236). The patients were divided in two groups ( < 70 and ≥ 70 bpm). Logistic regression was used to identify the predictors of HR ≥ 70 bpm. Results: Of patients with HFrEF and SR, 59% had HR ≥ 70 bpm at hospital discharge. At discharge, 96% and only 0.5% of the patients with HFrEF and SR received beta-blocker and ivabradine, respectively. In the HF groups < 70 and ≥ 70 bpm, only 11% and 4% of patients received beta-blocker target doses, respectively. There was no difference in the use of other guideline-recommended medications. Age, New York Heart Association class, HR on admission and lack of HR lowering medications were predictors of discharge HR ≥ 70 bpm. Conclusions: Heart rate control after hospitalization for HFrEF is unsatisfactory, which may be attributed to suboptimal doses of beta-blockers, and negligence in use other HR lowering drugs (including ivabradine).
Abstract
Background: Higher resting heart rate (HR) in patients with heart failure (HF) and sinus rhythm (SR) is associated with increased mortality. In patients hospitalized for HF, the aim herein, was to assess the use and dosage of guideline-recommended HR lowering medications, HR control at discharge and predictors of HR control. Methods: In the present study, were Polish participants of the European Society of Cardiology HF Long-Term (ESC-HF-LT) Registry. Those selected were hospitalized for HF, with reduced ejection fraction (HFrEF) and SR at discharge (n = 236). The patients were divided in two groups ( < 70 and ≥ 70 bpm). Logistic regression was used to identify the predictors of HR ≥ 70 bpm. Results: Of patients with HFrEF and SR, 59% had HR ≥ 70 bpm at hospital discharge. At discharge, 96% and only 0.5% of the patients with HFrEF and SR received beta-blocker and ivabradine, respectively. In the HF groups < 70 and ≥ 70 bpm, only 11% and 4% of patients received beta-blocker target doses, respectively. There was no difference in the use of other guideline-recommended medications. Age, New York Heart Association class, HR on admission and lack of HR lowering medications were predictors of discharge HR ≥ 70 bpm. Conclusions: Heart rate control after hospitalization for HFrEF is unsatisfactory, which may be attributed to suboptimal doses of beta-blockers, and negligence in use other HR lowering drugs (including ivabradine).
Keywords
acute heart failure, hospitalization, sinus rhythm, target heart rate, beta blocker, ivabradine
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About this articleTitle
Heart rate control and its predictors in patients with heart failure and sinus rhythm. Data from the European Society of Cardiology Long-Term Registry
Journal
Issue
Article type
Original Article
Published online
2022-08-11
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915
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345
DOI
10.5603/CJ.a2022.0076
Pubmed
Keywords
acute heart failure
hospitalization
sinus rhythm
target heart rate
beta blocker
ivabradine
Authors
Agata Tymińska
Krzysztof Ozierański
Marek Wawrzacz
Paweł Balsam
Cezary Maciejewski
Magdalena Kleszczewska
Magdalena Zawadzka
Michał Marchel
Maria G. Crespo-Leiro
Aldo P. Maggioni
Jarosław Drożdż
Grzegorz Opolski
Marcin Grabowski
Agnieszka Kapłon-Cieślicka
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