PMID- 33960305
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 2149-2271 (Electronic)
IS  - 2149-2263 (Print)
IS  - 2149-2263 (Linking)
VI  - 25
IP  - 5
DP  - 2021 May
TI  - Resting heart rate and real-life treatment modalities in outpatients with left 
      ventricular systolic dysfunction study: A multicenter, prospective, 
      observational, and national registry.
PG  - 304-312
LID - 10.14744/AnatolJCardiol.2020.13247 [doi]
AB  - OBJECTIVE: Heart rate (HR) reduction is associated with improved outcomes in 
      heart failure (HF). This multicenter, prospective, observational, and national 
      registry aimed to evaluate resting HR and the impacts of HR-related medications 
      in real-life clinical practice in patients with HF. METHODS: The Resting HR and 
      Real-Life Treatment Modalities in Outpatients with Left Ventricular Systolic 
      Dysfunction (REALITY HF) study enrolled 1054 patients with HF and left 
      ventricular ejection fraction (LVEF) of <40% from 16 centers. Clinical 
      characteristics, HR, and medications were noted (enrollment phase). A total of 
      487 patients with sinus rhythm and HR of >/=70 bpm were included in a further 
      4-month follow-up (FU) program (V0). Changes in HR and medications were 
      reevaluated at 1-month (V1) and 4-month (V2) FU visits. The Kansas City 
      Cardiomyopathy Questionnaire (KCCQ) was used to assess the quality of life (QoL) 
      of 320 patients in a 4-month FU program. RESULTS: During enrollment, 794 patients 
      (75.3%) were in sinus rhythm, in whom resting HR was 76.7+/-14 bpm, 69.1% had a 
      resting HR of >/=70 bpm, 79.1% were receiving beta blocker (BB), and 6.1% were 
      receiving ivabradine. Resting HR was lower in patients receiving BB (75.8+/-13 vs. 
      80.4+/-16 bpm; p=0.001); however, 65.8% of those still had a resting HR of >/=70 bpm. 
      A significant association was found between elevated HR and worse New York Heart 
      Association (NYHA) class, worse QoL, or lower LVEF. During the 4-month FU, 
      adjustment of HR-lowering therapy was left to the physician's discretion. Resting 
      HR significantly reduced from 83.6+/-12 (80) bpm at V0 to 78.6+/-13 (77) bpm at V1 
      (p=0.001) and further decreased to 73.0+/-11 (73) bpm at V2 (p=0.001). Patients 
      achieving a resting HR of <70 bpm were 21.7% at V1 (p=0.001) and 39.9% at V2 
      (p=0.001). KCCQ significantly increased from 59.7+/-23 (62.7) at V0 to 73.1+/-18 
      (78.5) at V2 (p=0.001). In addition, patients with NYHA I increased from 22.2% at 
      V0 to 29.2% at V1 and 39.4% at V2 (p=0.01). CONCLUSION: In real-life clinical 
      practice, elevated HR is highly prevalent in HF despite widely used BB therapy 
      and is associated with worse clinical picture. Therapeutic interventions 
      targeting HR significantly reduce HR, and HR lowering is associated with improved 
      clinical outcomes.
FAU - Cavusoglu, Yuksel
AU  - Cavusoglu Y
AD  - Department of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University; 
      Eskisehir-Turkey.
FAU - Kozan, Omer
AU  - Kozan O
AD  - Department of Cardiology, Faculty of Medicine, Baskent University; 
      Istanbul-Turkey.
FAU - Temizhan, Ahmet
AU  - Temizhan A
AD  - Department of Cardiology, Health Sciences University, Ankara City Hospital; 
      Ankara-Turkey.
FAU - Kucukoglu, Mehmet Serdar
AU  - Kucukoglu MS
AD  - Department of Cardiology, Istanbul University Cardiology Institute; 
      Istanbul-Turkey.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - Turkey
TA  - Anatol J Cardiol
JT  - Anatolian journal of cardiology
JID - 101652981
SB  - IM
MH  - *Heart Failure
MH  - Heart Rate
MH  - Humans
MH  - Outpatients
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Registries
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
PMC - PMC8114622
COIS- Conflict of interest: None declared
EDAT- 2021/05/08 06:00
MHDA- 2021/10/16 06:00
PMCR- 2021/01/20
CRDT- 2021/05/07 09:02
PHST- 2021/05/07 09:02 [entrez]
PHST- 2021/05/08 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/01/20 00:00 [pmc-release]
AID - ajc-25-5-304 [pii]
AID - 10.14744/AnatolJCardiol.2020.13247 [doi]
PST - ppublish
SO  - Anatol J Cardiol. 2021 May;25(5):304-312. doi: 
      10.14744/AnatolJCardiol.2020.13247.