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Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis
Although elevated resting heart rate is related to poor outcomes in heart failure (HF) with reduced ejection fraction, the association in HF with preserved ejection fraction (HFpEF) remains inconclusive. Therefore, we conducted a dose–response meta-analysis to examine the prognostic role of heart ra...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671878/ https://www.ncbi.nlm.nih.gov/pubmed/29069045 http://dx.doi.org/10.1097/MD.0000000000008431 |
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author | Shang, Xiaoke Lu, Rong Liu, Mei Xiao, Shuna Dong, Nianguo |
author_facet | Shang, Xiaoke Lu, Rong Liu, Mei Xiao, Shuna Dong, Nianguo |
author_sort | Shang, Xiaoke |
collection | PubMed |
description | Although elevated resting heart rate is related to poor outcomes in heart failure (HF) with reduced ejection fraction, the association in HF with preserved ejection fraction (HFpEF) remains inconclusive. Therefore, we conducted a dose–response meta-analysis to examine the prognostic role of heart rate in patients with HFpEF. We searched PubMed and Embase databases until April 2017 and manually reviewed the reference lists of relevant literatures. Random effect models were used to pool the study-specific hazard ratio (HR) of outcomes, including all-cause death, cardiovascular death, and HF hospitalization. Six studies with 7 reports were finally included, totaling 14,054 patients with HFpEF. The summary HR (95% confidence interval [CI]) for every 10 beats/minute increment in heart rate was 1.04 (1.02–1.06) for all-cause death, 1.06 (1.02–1.10) for cardiovascular death, and 1.05 (1.01–1.08) for HF hospitalization. Subgroup analyses indicated that these positive relationships were significant in patients with sinus rhythm but not in those with atrial fibrillation. There was also evidence for nonlinear relationship of heart rate with each of the outcomes (All P for nonlinearity < .05). Higher heart rate in sinus rhythm is a risk factor for adverse outcomes in patients with HFpEF. Future trials are required to determine whether heart rate reduction may improve the prognosis of HFpEF. |
format | Online Article Text |
id | pubmed-5671878 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-56718782017-11-22 Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis Shang, Xiaoke Lu, Rong Liu, Mei Xiao, Shuna Dong, Nianguo Medicine (Baltimore) 3400 Although elevated resting heart rate is related to poor outcomes in heart failure (HF) with reduced ejection fraction, the association in HF with preserved ejection fraction (HFpEF) remains inconclusive. Therefore, we conducted a dose–response meta-analysis to examine the prognostic role of heart rate in patients with HFpEF. We searched PubMed and Embase databases until April 2017 and manually reviewed the reference lists of relevant literatures. Random effect models were used to pool the study-specific hazard ratio (HR) of outcomes, including all-cause death, cardiovascular death, and HF hospitalization. Six studies with 7 reports were finally included, totaling 14,054 patients with HFpEF. The summary HR (95% confidence interval [CI]) for every 10 beats/minute increment in heart rate was 1.04 (1.02–1.06) for all-cause death, 1.06 (1.02–1.10) for cardiovascular death, and 1.05 (1.01–1.08) for HF hospitalization. Subgroup analyses indicated that these positive relationships were significant in patients with sinus rhythm but not in those with atrial fibrillation. There was also evidence for nonlinear relationship of heart rate with each of the outcomes (All P for nonlinearity < .05). Higher heart rate in sinus rhythm is a risk factor for adverse outcomes in patients with HFpEF. Future trials are required to determine whether heart rate reduction may improve the prognosis of HFpEF. Wolters Kluwer Health 2017-10-27 /pmc/articles/PMC5671878/ /pubmed/29069045 http://dx.doi.org/10.1097/MD.0000000000008431 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 3400 Shang, Xiaoke Lu, Rong Liu, Mei Xiao, Shuna Dong, Nianguo Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title | Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title_full | Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title_fullStr | Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title_full_unstemmed | Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title_short | Heart rate and outcomes in patients with heart failure with preserved ejection fraction: A dose–response meta-analysis |
title_sort | heart rate and outcomes in patients with heart failure with preserved ejection fraction: a dose–response meta-analysis |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671878/ https://www.ncbi.nlm.nih.gov/pubmed/29069045 http://dx.doi.org/10.1097/MD.0000000000008431 |
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