Heart rate control in heart failure: insights from nationwide multicenter registry HEROES
Rattachement africain : pl, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Aim HEart failuRe ObsErvational Study of the Polish Cardiac Society (HEROES) is a prospective, multi-center, observational all-comers study aimed to assess clinical profile of heart failure (HF) pts (patients) in a representative national sample (41 centers). This analysis reports aspects of heart rate (HR) control and rate control drugs use in the modern era (2022-24). Methods Analysis of eCRF prospectively collected data from 1422 out-pts and in-pts (median age 69, IQR 60-76, 28.6% females) with complete 16 months follow-up (median: 485 days, interquartile range: 397–599 days) providing 16.2% (231/1422) mortality rate. The cohort included HFrEF/mrEF/pEF subgroups (heart failure with reduced, mildly reduced, preserved ejection fraction: 59/ 14/ 27%). Among the analyzed 1168 non-paced patients 36% were in atrial fibrillation (AF). Results Median recorded HR at presentation was 77 beats per minute, bpm (IQR 67-90), higher in pts in AF (85 bpm; IQR 75-100 vs 75 bpm; IQR 65-85 in sinus rhythm, p<0.0001) and in hospitalized pts (80 bpm, IQR70-92) than in in-pts (70 bpm; 64-89, p<0.0001). Baseline use of beta-adrenolytics was 80% (increasing to 95% at discharge) and ivabradine was used in 4% (increase to 5%), amiodarone in 11% and digitalis in 8.5%. Only 59% of outpatients in sinus rhythm presented with baseline HR=<70 and lenient control in AF was adequate. Discharge HR improved to 70 bpm (IQR 65-80), higher in pts in AF (75 bpm; IQR 66-82 vs 70 bpm; IQR 63-78 in sinus rhythm, p<0.0001). Presentation heart rate was predictive for mortality, effect driven by in-pts and pts insinus rhythm. Logistic regression showed 1% excess mortality risk per 1bpm increase in presentation HR. Kaplan-Meier curves analysis showed hazard ratio of 1.5 (p=0.0045) for dying in pts with snapshot HR>82 at presentation. For in-pts prediction cutoff was identified at admission HR >73bpm (HR=1.33 with borderline significance). Pts with HFpEF showed most significant relationship of presentation heart rate and mortality (logistic regression p=0.0004 vs p=0.12 for HFmrEF and p=0.55 for HFpEF). Presentation HR correlated with serum NT-proBNP (r=0.24, p<0.001) and inversely with KCCQ score (r=0.25, p<0.001). Conclusions Among the Polish patients from snapshot HEROES registry accelerated heart rate is common, correlating with worse Nt-proBNP and quality of life. HR at presentation is weakly but significantly related with total 16-months mortality with optimal cutoff >82bpm for entire cohort and sinus rhythm pts, and with >73bpm for hospitalized pts. Elevated heart rate was a remarkable predictor of mortality in the subset of patients with preserved ejection fraction.Survival according to presentation HR
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Heart rate control in heart failure: insights from nationwide multicenter registry HEROES
- Date Crossref
- 01/11/2025
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Medical University of Lodz pays non établi dans la noticeUniversité ou école supérieure
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National Academy of Medicine pays non établi dans la noticeOrganisation à but non lucratif
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Medical University of Warsaw pays non établi dans la noticeUniversité ou école supérieure
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Institute of Cardiology pays non établi dans la noticeStructure de recherche
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Jagiellonian University pays non établi dans la noticeUniversité ou école supérieure
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Wroclaw Medical University pays non établi dans la noticeUniversité ou école supérieure
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Gdańsk Medical University pays non établi dans la noticeUniversité ou école supérieure
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2P-Info (Poland) pays non établi dans la noticeEntreprise
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Jan Kochanowski University pays non établi dans la noticeUniversité ou école supérieure
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Military Institute of Medicine pays non établi dans la noticeStructure de recherche
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Medical University of Gdansk pays non établi dans la noticeUniversité ou école supérieure
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Swietokrzyskie Cardiology Centre pays non établi dans la noticeInstitution
Medical University of Lodz, National Academy of Medicine et Medical University of Warsaw, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.