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Statements

Subject Item
n2:RIV%2F00023001%3A_____%2F13%3A00058760%21RIV14-MZ0-00023001
rdf:type
n15:Vysledek skos:Concept
rdfs:seeAlso
http://ac.els-cdn.com/S2213177913001248/1-s2.0-S2213177913001248-main.pdf?_tid=94441636-8296-11e3-82e8-00000aab0f27&acdnat=1390307079_ed84d8efc224ca7767fd08705272bd65
dcterms: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.
dcterms: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
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
skos:notation
RIV/00023001:_____/13:00058760!RIV14-MZ0-00023001
n15:predkladatel
n19:ico%3A00023001
n3:aktivita
n6:I n6:P
n3:aktivity
I, P(LH12052)
n3:cisloPeriodika
3
n3:dodaniDat
n18:2014
n3:domaciTvurceVysledku
n4:4066332 n4:6807437 n4:9886982 n4:7977131 n4:6599370 n4:5053587
n3:druhVysledku
n10:J
n3:duvernostUdaju
n14:S
n3:entitaPredkladatele
n12:predkladatel
n3:idSjednocenehoVysledku
102679
n3:idVysledku
RIV/00023001:_____/13:00058760
n3:jazykVysledku
n20:eng
n3:klicovaSlova
heart rate, heart failure
n3:klicoveSlovo
n17:heart%20failure n17:heart%20rate
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[7C1A558320D0]
n3:nazevZdroje
Journal of the American college of cardiology : Heart failure
n3:obor
n13:FA
n3:pocetDomacichTvurcuVysledku
6
n3:pocetTvurcuVysledku
9
n3:projekt
n16:LH12052
n3:rokUplatneniVysledku
n18:2013
n3:svazekPeriodika
1
n3:tvurceVysledku
Beneš, Jan Bendlova, B. Borlaug, BA Jabor, Antonín Kautzner, Josef Kotrč, Martin Melenovský, Vojtěch Jarolim, P. Lefflerová, Kateřina
s:issn
2213-1779
s:numberOfPages
8
n11:doi
10.1016/j.jchf.2013.03.008