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KMID : 1812720200020010001
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International Journal of Heart Failure
2020 Volume.2 No. 1 p.1 ~ p.11
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Optimization of Heart Failure Treatment by Heart Rate Reduction
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Bohm Michael
Bewarder Yvonne
Kindermann Ingrid
Slawik Jonathan
Wintrich Jan
Werner Christian
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Abstract
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Heart failure (HF) treatment should be optimized in addition to guideline-directed and recommended drugs to achieve an appropriate heart rate (i.e. 50?60 bpm) by ivabradine in patients with a heart rate >70 bpm in sinus rhythm and with an ejection fraction ≤35%. Heart rate reduction was to reduce cardiovascular death and HF hospitalization dependent on baseline resting heart rate. In particular in patients at a heart rate >75 bpm, a reduction in cardiovascular death, all-cause death, HF death, HF hospitalization and all-cause hospitalization has been observed. The optimal heart rate achieved appears to be between 50?60 bpm, if well tolerated as in these patients the lowest event rate is observed on treatment. Heart rate reduction is, therefore, a treatable risk factor in chronic HF. Observational studies support the concept that it is a risk indicator in other cardiovascular and non-cardiovascular conditions. Whether heart rate reduction is also modifying risk in other conditions than chronic HF should be explored in prospective clinical trials.
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KEYWORD
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Heart rate, Chronic heart failure, Ivabradine, Patient outcomes, Cardiovascular comorbidities, Heart rhythm
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