Heart rate as a therapeutic target in heart failure?
Department of Cardiology, Policlinico San Matteo, Institute of Care and Research, Pavia, Italy
* Prof. Luigi Tavazzi, Divisione di Cardiologia, IRCCS Policlinico San Matteo, P.le Golgi, 2, 27100 Pavia, Italy.
Abstract
A common finding in all clinical trials on heart failure is a negative correlation between heart rate and duration of life. In several studies this was found in both patients taking and those not taking beta-blocker agents. In postinfarct patients increasing mortality with increasing heart rate was found in the absence and in the presence of left ventricular dysfunction. Moreover beneficial effects of neurohormonal modulators were found to be greater in heart failure patients with higher heart rate. Thus heart rate can be considered a target for medical intervention, and therapeutic attempts focused on direct control of heart rate have a good rationale.
Key Words: Heart rate • Heart failure • If channel • 
channel antagonist • Ivabradine
References
- Ferrari R, Rapezzi C, Lombardi F. The revival of heart rate. Eur Heart J Suppl. 1999;1(suppl H):853–854
- Zuanetti G, Hernàndez-Bernal F, Rossi A, et al. Relevance of heart rate as a prognostic factor in myocardial infarction: the GISSI experience. Eur Heart J Suppl. 1999;1(suppl H):52–56
- The Consensus Trial Study GroupSwedberg K, Eneroth P, Kjekshus J, Wilhelmsen L. Hormone regulation of cardiovascular function in patients with severe congestive heart failure and their relation to mortality. Circulation. 1990;82:1730–1737
[Abstract/Free Full Text] - St. John Sutton M, Pfeffer MA, Moye L, et al. Cardiovascular death and left ventricular remodelling two years after myocardial infarction. Baseline predictors and impact of long-term use of captopril: information from the survival and ventricular enlargement (SAVE) trial. Circulation. 1997;96:3294–3299
[Abstract/Free Full Text] - Peters KG, Kienzle MG. Severe cardiomyopathy due to chronic rapidly conducted atrial fibrillation: complete recovery after restoration of sinus rhythm. Am J Med. 1988;85:242–244[Web of Science][Medline]
- Opasich C, Rapezzi Lucci D, et al, Italian Network on Congestive Heart Failure (IN-CHF) Investigators. Precipitating factors and decision-making processes of short-term worsening heart failure despite ‘optimal’ treatment (from the In-CHF Registry). Am J Cardiol. 2001;88:382–387[CrossRef][Web of Science][Medline]
- Leimbach WM, Wallin BG, Victor RG, et al. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. Circulation. 1986;73:913–919
[Abstract/Free Full Text] - Grassi G, Seravalle G, Cattaneo BM, et al. Sympathetic activation and loss of reflex sympathetic control in mild congestive heart failure. Circulation. 1995;92:3206–3211
[Abstract/Free Full Text] - Sandvik Erikssen J, Ellestad M, et al. Heart rate increase and maximal heart rate during exercise as predictors of cardiovascular mortality: a 16-year follow-up study of 1960 healthy men. Coron Artery Dis. 1995;6:667–679[Web of Science][Medline]
- Kreutz R, Struk B, Stock P, et al. Evidence for primary genetic determination of heart rate regulation. Chromosomal mapping of a genetic locus in the rat. Circulation. 1997;96:1078–1081
[Abstract/Free Full Text] - Gundersen T. Influence of heart size on mortality and reinfarction in patients treated with timolol after myocardial infarction. Br Heart J. 1983;50:135–139
[Abstract/Free Full Text] - Chadda K, Goldstein S, Byington R, et al. Effect of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation. 1986;73:503–510
[Abstract/Free Full Text] - CIBIS-II Investigators and Committees. The Cardiac insufficiency Bisoprolol Study II: a randomised trial. Lancet. 1999;353:9–13[CrossRef][Web of Science][Medline]
- MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001–2007[CrossRef][Web of Science][Medline]
- Packer M, Coats AJS, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med. 2001;344:1651–1658
[Abstract/Free Full Text] - Nul DR, Doval HC, Grancelli HO, et al. Heart rate is a marker of amiodarone mortality reduction in severe heart failure. J Am Coll Cardiol. 1997;29:1199–1205[Abstract]
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