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| Description
| - Objectives: The purpose of this study was to compare the prognostic impact of clinical and biomarker correlates of resting heart rate (HR) and chronotropic incompetence in heart failure (HF) patients. Background: The mechanisms and underlying pathophysiological influences of HR abnormalities in HF are incompletely understood. Methods: In a prospective pilot study, 81 patients with advanced systolic HF (97% were receiving beta-blockers) and 25 age-, sex-, and body-size matched healthy controls underwent maximal cardiopulmonary exercise testing with sampling of neurohormones and biomarkers. Results: Two-thirds of HF patients met criteria for chronotropic incompetence. Resting HR and HR reserve (HRR, a measure of chronotropic response) were not correlated with each other and were associated with distinct biomarker profiles. Resting HR correlated with increased myocardial stress (B-type natriuretic peptide [BNP]: r 1/4 0.26; pro A-type natriuretic peptide: r 1/4 0.24; N-terminal(NT)-proBNP: r 1/4 0.32) and inflammation (leukocyte count: r 1/4 0.28; highsensitivity C-reactive protein assay: r 1/4 0.25). In contrast, HRR correlated with the neurohumoral response to HF (copeptin: r 1/4 0.33; norepinephrine: r 1/4 0.29) but not with myocyte stress or injury reflected by natriuretic peptides or hs-troponin I. Patients in the lowest chronotropic incompetence quartile (HRR 0.38) displayed more advanced HF, reduced exercise capacity, ventilatory inefficiency, and poorer quality of life. Over a median follow-up of 17 months, the combined endpoint of death or urgent transplant/assist device implantation occurred more frequently in patients with higher resting HR (>67 beats/min) or lower HRR, with bothmarkers providing additive prognostic information. Conclusions: Increased resting HR and chronotropic incompetence may reflect different pathophysiological processes, provide incremental prognostic information, and represent distinct therapeutic targets.
- Objectives: The purpose of this study was to compare the prognostic impact of clinical and biomarker correlates of resting heart rate (HR) and chronotropic incompetence in heart failure (HF) patients. Background: The mechanisms and underlying pathophysiological influences of HR abnormalities in HF are incompletely understood. Methods: In a prospective pilot study, 81 patients with advanced systolic HF (97% were receiving beta-blockers) and 25 age-, sex-, and body-size matched healthy controls underwent maximal cardiopulmonary exercise testing with sampling of neurohormones and biomarkers. Results: Two-thirds of HF patients met criteria for chronotropic incompetence. Resting HR and HR reserve (HRR, a measure of chronotropic response) were not correlated with each other and were associated with distinct biomarker profiles. Resting HR correlated with increased myocardial stress (B-type natriuretic peptide [BNP]: r 1/4 0.26; pro A-type natriuretic peptide: r 1/4 0.24; N-terminal(NT)-proBNP: r 1/4 0.32) and inflammation (leukocyte count: r 1/4 0.28; highsensitivity C-reactive protein assay: r 1/4 0.25). In contrast, HRR correlated with the neurohumoral response to HF (copeptin: r 1/4 0.33; norepinephrine: r 1/4 0.29) but not with myocyte stress or injury reflected by natriuretic peptides or hs-troponin I. Patients in the lowest chronotropic incompetence quartile (HRR 0.38) displayed more advanced HF, reduced exercise capacity, ventilatory inefficiency, and poorer quality of life. Over a median follow-up of 17 months, the combined endpoint of death or urgent transplant/assist device implantation occurred more frequently in patients with higher resting HR (>67 beats/min) or lower HRR, with bothmarkers providing additive prognostic information. Conclusions: Increased resting HR and chronotropic incompetence may reflect different pathophysiological processes, provide incremental prognostic information, and represent distinct therapeutic targets. (en)
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| Title
| - Resting heart rate and heart rate reserve in advanced heart failure have distinct pathophysiologic correlates and prognostic impact
- Resting heart rate and heart rate reserve in advanced heart failure have distinct pathophysiologic correlates and prognostic impact (en)
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| skos:prefLabel
| - Resting heart rate and heart rate reserve in advanced heart failure have distinct pathophysiologic correlates and prognostic impact
- Resting heart rate and heart rate reserve in advanced heart failure have distinct pathophysiologic correlates and prognostic impact (en)
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| skos:notation
| - RIV/00023001:_____/13:00058760!RIV14-MZ0-00023001
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| http://linked.open...avai/predkladatel
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| http://linked.open...avai/riv/aktivita
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| http://linked.open...avai/riv/aktivity
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| http://linked.open...iv/cisloPeriodika
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| http://linked.open...vai/riv/dodaniDat
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| http://linked.open...aciTvurceVysledku
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| http://linked.open.../riv/druhVysledku
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| http://linked.open...iv/duvernostUdaju
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| http://linked.open...titaPredkladatele
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| http://linked.open...dnocenehoVysledku
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| http://linked.open...ai/riv/idVysledku
| - RIV/00023001:_____/13:00058760
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| http://linked.open...riv/jazykVysledku
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| http://linked.open.../riv/klicovaSlova
| - heart rate, heart failure (en)
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| http://linked.open.../riv/klicoveSlovo
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| http://linked.open...odStatuVydavatele
| - US - Spojené státy americké
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| http://linked.open...ontrolniKodProRIV
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| http://linked.open...i/riv/nazevZdroje
| - Journal of the American college of cardiology : Heart failure
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| http://linked.open...in/vavai/riv/obor
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| http://linked.open...ichTvurcuVysledku
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| http://linked.open...cetTvurcuVysledku
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| http://linked.open...vavai/riv/projekt
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| http://linked.open...UplatneniVysledku
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| http://linked.open...v/svazekPeriodika
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| http://linked.open...iv/tvurceVysledku
| - Kautzner, Josef
- Beneš, Jan
- Jabor, Antonín
- Melenovský, Vojtěch
- Lefflerová, Kateřina
- Kotrč, Martin
- Borlaug, BA
- Bendlova, B.
- Jarolim, P.
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| issn
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| number of pages
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| http://bibframe.org/vocab/doi
| - 10.1016/j.jchf.2013.03.008
|
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