Abstract 10255: Resting Heart Rate as Predictor for Development of Heart Failure and Left Ventricular Dysfunction: The Multi-Ethnic Study of Atherosclerosis
Background: Resting heart rate (RHR) has been introduced as a predictor for heart failure (HF) in patients with cardiovascular (CV) disease. However, this association is not well described in an asymptomatic multi-ethnic population of both genders. This study investigates the relationship between baseline RHR and to development of HF and left ventricular (LV) dysfunction.
Methods: Participants in the Multi-Ethnic Study of Atherosclerosis (MESA, n=6814) had RHR measured at inclusion. Incident HF was registered (n=139) during follow-up (median 5.8 years). Changes in ejection fraction (EF) and peak circumferential strain (Ecc) were measured as markers of developing global and regional LV function in 1056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and changes in Ecc and EF (multiple linear regression models) were adjusted for age, gender, ethnicity, exercise- and education level, alcohol- and cigarette use, body mass index, height, blood pressure, diabetes, cholesterol, calcium score, LV end-diastolic volume and mass, and medication (incl. beta-blockers) in addition to RHR.
Results: The Cox analysis demonstrated that for 1 bpm increase in RHR there was a 4% increase in adjusted relative risk for incident HF (Hazard Ratio, 1.04; 95% CI, 1.02 to 1.07; P<0.001). Importantly, for the highest quartile in RHR we observed a threefold increase in adjusted relative risk for incident HF (Figure), when compared to the lowest quartile. Adjusted multiple regression models demonstrated that RHR was positively associated with deteriorating Ecc and EF, even when all CV events were excluded from the model.
Conclusions: Elevated resting heart rate is associated with increased risk for incident heart failure in asymptomatic participants in MESA. Furthermore, higher heart rate is related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and clinical cardiovascular events.
- © 2010 by American Heart Association, Inc.