Importance of baseline heart rate as a predictor of cardiac functional recovery in newly diagnosed heart failure with reduced ejection fraction

Abstract

The novel findings of our analysis reveal that the only predictor of LVR in this study was a low baseline HR. Early modulation of HR in newly diagnosed HF patients may increase the rates of LVR.

Left Ventricular Ejection Fraction Recovery in Patients with Heart Failure and Reduced Ejection Fraction Treated with Sacubitril/Valsartan

“…On the other hand, we did not find any differences in heart rate between patients with LVEF recovery and those without, neither at the beginning nor at the end of follow-up, despite the fact that the former received more often and higher doses of beta-blockers. These findings may be due to the fact that the average heart rate of the patients in our series is low, in line with recent studies, like that by Valika et al [11], who demonstrate better clinical outcomes in patients with a heart rate < 70 bpm.…”

“…In the multivariate analysis, carrying an ICD was the only independent variable significantly associated with a lower probability of LVEF recovery (HR 0.25, 95% CI 0.13-0.47, p < 0.0001). This finding has already been observed in previous studies [10,11,20] and may be related to the fact that an ICD is recommended to reduce the risk of sudden death and all-cause mortality in patients with symptomatic HF (NYHA classes II-III) and an LVEF ≤35% despite ≥3 months of optimal medical therapy [5]. Consequently, patients with an ICD in our cohort were more likely to have a diagnosis of chronic HF much earlier in time to the others, thus entailing a lower probability of LVEF recovery.…”

“…Although the benefit of these treatments is unambiguous, the reported rates of LVEF recovery vary (between 19 and 50% depending on the series), in part because of lack of unique criteria. Consequently, the predictors of recovery do not seem to be clearly established [7][8][9][10][11][12], though patients with LVEF recovery have a better prognosis [20]. SV is recommended in patients with LVEF ≤35% and symptomatic HF despite optimized medical treatment in order to reduce morbimortality [5,6].…”

“…A significant number of patients with LVEF dysfunction experience ventricular function recovery during follow-up. Different studies have tried to identify parameters associated with improved of ejection fraction in these patients throughout their follow-up, as well as its impact in terms of cardiovascular events and quality of life [7][8][9][10][11][12]. However, the characteristics associated with this recovery in patients treated with SV have not yet been well established.…”

Outcomes of guideline-based medical therapy in patients with acute heart failure and reduced left ventricular ejection fraction

“…Suboptimal dosing in patients with HFrEF is a well-known phenomenon which has been reported by several previous studies. [29,37,[39][40][41] The positive impact of treatment of Gulf CARE patients with acute HFrEF with ACE inhibitors or ARBs in terms of reduced mortality risk has been previously reported. [42] In this study, we report multiple significant benefits to being treated with three GBMT medications in comparison to a single medication in Gulf CARE patients with HFrEF.…”