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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2017 ; 96
(43
): e8431
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Heart rate and outcomes in patients with heart failure with preserved ejection
fraction: A dose-response meta-analysis
#MMPMID29069045
Shang X
; Lu R
; Liu M
; Xiao S
; Dong N
Medicine (Baltimore)
2017[Oct]; 96
(43
): e8431
PMID29069045
show ga
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.