J Korean Soc Hypertens.  2012 Mar;18(1):38-45. 10.5646/jksh.2012.18.1.38.

Significance of Resting Heart Rate in Chronic Heart Failure: Data from Cardiac Insufficiency of Various Origin in Jeonbuk (CION-J) Registry

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea. jjwcar@wonkwang.ac.kr
  • 2Division of Cardiology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • 3Division of Cardiology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

Abstract

BACKGROUND
Chronic heart failure (HF) is a leading cause of morbidity and mortality in industrialized countries. Raised resting heart rate (HR) is a marker of cardiovascular risk in general population, as well as in patients with hypertension and coronary artery disease. We studied the association between HR and cardiovascular events in patients with Cardiac Insufficiency of Various Origin in Jeonbuk (CION-J) registry.
METHODS
CION-J registry was a multicenter, prospective database for chronic HF. From January 2010 to December 2010, 356 HF patients who clinically stabilized at least 2 weeks were analyzed. According to resting HR, the patients divided into the tertile (lower tertile < 70/min, n = 129; middle tertile 70-80/min, n = 114; upper tertile > 80/min, n = 113). Clinical outcomes during 6-month period were compared by resting HR.
RESULTS
Patients with upper tertile revealed higher New York Heart Association (NYHA) class than in those with lower tertile. From the lower to the upper tertile, the incidence of composite events of death, non-fatal myocardial infarction, ischemic stroke, and hospitalization for HF were increased(3.1%, 4.4%, 16.8%, respectively; p < 0.001). Patients with upper tertile had a higher predictive value for the incidence of death (hazard ratio, 5.8; p = 0.036) and hospitalization for HF (hazard ratio, 6.4; p < 0.001) than in those with middle and lower tertile. In multivariate analysis, NYHA class III/IV, resting HR > 80/min, and ejection fraction < 35% were independent predictors of adverse events.
CONCLUSIONS
High resting HR (> 80/min) is a prognostic factor in chronic HF. Optimal treatment to reduce HR should be emphasized to improve prognosis of HF.

Keyword

Heart failure; Heart rate; Prognosis

MeSH Terms

Coronary Artery Disease
Developed Countries
Heart
Heart Failure
Heart Rate
Hospitalization
Humans
Hypertension
Incidence
Multivariate Analysis
Myocardial Infarction
New York
Prognosis
Prospective Studies
Stroke

Figure

  • Fig. 1 Adverse events during 6-month period according to the tertile of resting heart rate (HR). (A) Death. (B) Stroke. (C) Hospitalization for heart failure (HF). (D) All events.

  • Fig. 2 Event-free survival curves of death and hospitalization for heart failure (HF) according to the resting heart rate (HR). (A) Death. (B) Hospitalization for HF. CI, confidential interval.


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