Elevated Heart Rate in Combination with Elevated Blood Pressure Predicts Lower Cardiovascular Mortality in Acute Decompensated Heart Failure

Hiki, Masaru; Iwata, Hiroshi; Takasu, Kiyoshi; Nojiri, Shuko; Ishikawa, Go; Chikata, Yuichi; Mattson, Peter C.; Kasai, Takatoshi; Miyazaki, Tatsuya; Inoue, Kenji; Fujiwara, Yoshihiro; Sumiyoshi, Masataka; Kinugawa, Koichiro; Daida, Hiroyuki

doi:10.1536/ihj.19-521

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…The clinical impact of baseline HR at admission has already been reported in several studies 22,23 ; however, the results were controversial. The sub‐analysis in this study showed that the group with higher HR at admission had a better prognosis.…”

Section: Discussionmentioning

confidence: 95%

Clinical impact of heart rate change in patients with acute heart failure in the early phase

et al. 2021

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Aims Patients with acute heart failure (AHF) often present with an increased heart rate (HR), and the HR changes dramatically after initial treatment for AHF. However, the HR change after admission and the relationship between HR change in the early phase and prognosis have not been fully elucidated. Methods and results From a multicentre AHF registry, we retrospectively evaluated 1527 consecutive patients admitted with AHF. HR change (%) was calculated by [HR (at admission) À HR (24 h after admission)] × 100∕HR (at admission). The median HR change was 15.1% (range, 2.0-28.4%). The HR decreased most in the first 24 h and then gradually thereafter [admission: 98 (81-117) b.p.m., 24 h: 80 (70-92) b.p.m., 48 h: 78 (68-90) b.p.m., and 72 h: 77 (67-88) b.p.m.]. In Kaplan-Meier analysis, the cumulative event-free rates in the composite endpoint of death and rehospitalization due to AHF showed better according to larger HR change (P = 0.012, log rank). Cox proportional hazards analysis showed that HR change was a prognostic factor for composite endpoint adjusted by age and sex [hazard ratio, 0.995; 95% confidence interval (CI), 0.991-0.998; P = 0.006]. HR change was associated with outcome adjusted by age and sex in patients with sinus rhythm (hazard ratio, 0.993; 95% CI, 0.988-0.999; P = 0.015), but not in patients with atrial fibrillation (hazard ratio, 0.996; 95% CI, 0.990-1.002; P = 0.15). Conclusions A decrease in HR in the first 24 h after admission indicates better prognosis in patients with AHF, although the prognostic influence may differ between patients with sinus rhythm and those with atrial fibrillation.

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Section: Discussionmentioning

confidence: 95%

Clinical impact of heart rate change in patients with acute heart failure in the early phase

et al. 2021

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“…Unfavorable tendencies of decreased systolic BP or HR changes were not observed; these have an adverse impact on the prognosis in AHF. 24,25 In evaluating the supply and use of oxygen by the skeletal muscles, we used NIRS, whose suitability has previously been demonstrated. [26][27][28] Near-infrared spectroscopy has commonly been used to evaluate the dynamic balance between the delivery and extraction of oxygen in the tissue during surgery or exercise.…”

Section: Discussionmentioning

confidence: 99%

Impact of assisted exercises on skeletal muscle oxygenation levels in men with acutely decompensated heart failure

Kisiel¹,

Siennicka

Josiak

et al. 2022

Adv Clin Exp Med

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Background. The complex clinical status of modern day patients hospitalized due to acute heart failure (AHF) results from their advanced age, comorbidities, frailty, heart failure symptoms (including massive swelling of the lower limb), and dramatic reduction of exercise tolerance. Hence, there is a need to implement physiotherapeutic procedures as early as possible, aiming to both accelerate the restoration of clinical stabilization and prevent post-hospital disability.Objectives. We investigated whether assisted lower limb exercises have an impact on perfusion and oxygenation in skeletal muscle and if they are feasible in patients with AHF. Materials and methods.We examined 34 men (age: 66 ±11 years; left ventricular ejection fraction (LVEF): 34 ±11%; clinical presentation: 31 wet-warm and 3 wet-cold). The intervention (carried out on the 2 nd day of hospitalization) included: 1) a 3-minute rest period; 2) an exercise phase (45 repetitions of assisted flexion and extension of the lower limb; and 3) a 10-minute relaxation period. We analyzed blood pressure (BP), heart rate (HR), respiratory rate (RR), tissue oxygenation (reflected by oxygen saturation measured with a pulse oximeter), and changes in peripheral tissue perfusion (reflected by the tissue oxygenation index (TOI) measured with near-infrared spectroscopy (NIRS)).Results. The hemodynamic parameters (both ∆HR and ∆systolic BP) and oxygen saturation did not change (all p > 0.05), whereas the RR declined (p < 0.001). The exercises improved venous outflow (reflected by decreased oxygenated, deoxygenated and total hemoglobin, all p < 0.05) and increased peripheral tissue perfusion, as reflected by the TOI (p < 0.05). The patients reported relief and lack of dyspnea during and after the assisted exercises.Conclusions. The physiotherapeutic intervention improved both venous outflow and muscle oxygenation in men with AHF. The presented protocol was safe, feasible and well-tolerated, and resulted in relief for the patients. We believe that such procedures might be recommended for the initial period of rehabilitation in this challenging subgroup of patients.

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“…eart failure (HF) is a major cause of death and hospital admission worldwide. [1][2][3] Hospital admission due to worsened HF is an important dimension of the clinical practice of patients with HF, 4,5) and readmission due to worsened HF occurs frequently after the onset of HF. 2,6) Furthermore, previous studies have showed that prior history of hospital admission was associated with poor clinical outcomes for HF patients.…”

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confidence: 99%

Serial Changes in Clinical Presentations and Outcomes of 5,740 Patients Requiring Repeated Hospital Admissions (Four or More Times) due to Worsened Heart Failure

et al. 2020

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Elevated Heart Rate in Combination with Elevated Blood Pressure Predicts Lower Cardiovascular Mortality in Acute Decompensated Heart Failure

Cited by 5 publications

References 23 publications

Clinical impact of heart rate change in patients with acute heart failure in the early phase

Clinical impact of heart rate change in patients with acute heart failure in the early phase

Impact of assisted exercises on skeletal muscle oxygenation levels in men with acutely decompensated heart failure

Serial Changes in Clinical Presentations and Outcomes of 5,740 Patients Requiring Repeated Hospital Admissions (Four or More Times) due to Worsened Heart Failure

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