Prognostic Value of the Change in Heart Rate From the Supine to the Upright Position in Patients With Chronic Heart Failure
| Autor: | Se-Il Yoon, Hans-Peter Brunner-La Rocca, Marzena Zurek, Matthias Pfisterer, Thomas M. Suter, Daniel Tobler, Hans Rickli, Barbara Julius, Stephanie Kiencke, Micha T. Maeder |
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| Přispěvatelé: | Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.05 - Clinical heart failure, MUMC+: MA Cardiologie (9), RS: CARIM - R2.02 - Cardiomyopathy |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Supine position Posture TIME‐CHF Renal function heart failure 030204 cardiovascular system & hematology TIME-CHF 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine Heart rate Supine Position medicine Humans Sinus rhythm 030212 general & internal medicine Original Research Aged business.industry heart rate/heart rate variability Hazard ratio autonomic nervous system medicine.disease Confidence interval Hospitalization Clinical trial Heart failure Chronic Disease Cardiology Female prognosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Heart Association, 5(8):e003524. Wiley Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background The prognostic value of the change in heart rate from the supine to upright position (∆ HR ) in patients with chronic heart failure ( HF ) is unknown. Methods and Results ∆ HR was measured in patients enrolled in the Trial of Intensified Medical Therapy in Elderly Patients with Congestive Heart Failure ( TIME ‐ CHF ) who were in sinus rhythm and had no pacemaker throughout the trial (n=321). The impact of ∆ HR on 18‐month outcome ( HF hospitalization‐free survival) was assessed. In addition, the prognostic effect of changes in ∆ HR between baseline and month 6 on outcomes in the following 12 months was determined. A lower ∆ HR was associated with a higher risk of death or HF hospitalization (hazard ratio 1.79 [95% confidence interval {95% CI } 1.19‐2.75] if ∆ HR ≤3 beats/min [bpm], P =0.004). In the multivariate analysis, lower ∆ HR remained an independent predictor of death or HF hospitalization (hazard ratio 1.75 [95% CI , 1.18‐2.61] if ∆ HR ≤3 bpm, P =0.004) along with ischemic HF etiology, lower estimated glomerular filtration rate, presence and extent of rales, and no baseline β‐blocker use. In patients without event during the first 6 months, the change in ∆ HR from baseline to month 6 predicted death or HF hospitalization during the following 12 months (hazard ratio=2.13 [95% CI 1.12–5.00] if rise in ∆ HR P =0.027). Conclusions ∆ HR as a simple bedside test is an independent prognostic predictor in patients with chronic HF . ∆ HR is modifiable, and changes in ∆ HR also provide prognostic information, which raises the possibility that ∆ HR may help to guide treatment. Clinical Trial Registration Information URL : www.isrctn.org . Unique identifier: ISRCTN 43596477. |
| Databáze: | OpenAIRE |
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