Abstract 16254: Heart Rate as a Prognostic Marker in Patients With Heart Failure With Preserved Ejection Fraction
Introduction: Higher heart rate is associated with worse outcomes in patients with heart failure (HF) and reduced left ventricular ejection fraction (EF). This association is less certain in patients with HF and preserved EF (HFpEF).
Methods: The Atherosclerosis Risk in Communities (ARIC) HF community surveillance study sampled HF hospitalizations from 2005-2010 identified by ICD discharge codes (for patients aged ≥ 55 years from 4 US communities). Patients with validated acute decompensated HF (ADHF) and EF ≥50% were categorized as HFpEF. We examined the association between quartiles of heart rate (HRt) at admission and 1-year mortality in HFpEF patients using multivariable Cox-proportional hazard models. Patients with atrial fibrillation, pacemakers and ICDs, and patients with missing covariates were excluded. Analyses were weighted to account for the stratified sampling design.
Results: The final study sample included 874 HFpEF hospitalizations (weighted n=3934). Patients with lower HRt were more often male; more often had hypertension, less lung disease, had lower eGFR values and were more often on beta-blockers and diuretics. Unadjusted Kaplan Meier curves showed significant survival differences between the HRt quartiles (Fig). After adjusting for demographics, comorbidities, labs and medications (including beta blockers), compared to patients in the lowest HRt quartile, patients with HRt in the highest quartile had the highest risk of mortality (hazard ratio [95% CI] 2.07 [1.22-3.52]); patients in the 3rd and 2nd quartiles also had elevated risks (1.92 [1.22-3.04] and 1.44 [0.90-2.23]).
Conclusions: There is a strong association between increasing HRt at admission and 1-year mortality in acute decompensated HFpEF.
- heart rate
- heart failure with preserved ejection fraction
- beta blockers
- acute decompansated heart failure
Author Disclosures: O. Bilen: None. S. Marks: None. L.M. Wruck: None. U. Khalid: None. S.S. Virani: None. V. Nambi: None. H. Jneid: None. L. Cunningham: None. P. Chang: None. B. Bozkurt: None. A. Deswal: None.
- © 2015 by American Heart Association, Inc.