Although an elevated resting heart rate is linked to worse outcomes in heart failure (HF) with a lower ejection fraction, the link in HF with a higher ejection fraction (HFpEF) is still unclear. For a study, the researchers conducted a dose-response meta-analysis to determine if heart rate has a predictive role in patients with HFpEF. For a study, the researchers manually checked the reference lists of relevant literature after searching PubMed and Embase databases until April 2017. The outline-specific hazard ratios (HRs) of outcomes, such as all-cause death, cardiovascular death, and HF hospitalization, were pooled using random-effects models. Finally, six outlines with 7 reports were considered, totaling 14,054 HFpEF patients. For every 10 beats/minute increase in heart rate, the summary HR (95% confidence interval [CI]) was 1.04 (1.02-1.06) for all-cause mortality, 1.06 (1.02-1.10) for cardiovascular death, and 1.05 (1.01-1.08) for HF hospitalisation. The beneficial correlations were significant in patients with sinus rhythm but not in those with atrial fibrillation, according to subgroup analyses. There was also evidence of a nonlinear link between heart rate and each outcome (all P values for nonlinearity were <.05). In patients with HFpEF, a higher heart rate in sinus rhythm is linked to poor outcomes. Future trials will be needed to determine if lowering the heart rate improves the prognosis of HFpEF.
Link:pubmed.ncbi.nlm.nih.gov/29069045/
