Imperial College London
Alternate

ProfessorMartinCowie

Faculty of Medicine, National Heart & Lung Institute

Visiting Professor
 
 
 
//

Contact

 

+44 (0)20 7351 8856m.cowie

 
 
//

Assistant

 

Mr Jacob Chapman +44 (0)20 7351 8856

 
//

Location

 

Chelsea WingRoyal Brompton Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Vukadinovic:2017:10.1002/ejhf.902,
author = {Vukadinovic, AN and Vukadinovic, D and Borer, J and Cowie, M and Komajda, M and Lainscak, M and Swedberg, K and Boehm, M},
doi = {10.1002/ejhf.902},
journal = {European Journal of Heart Failure},
pages = {1230--1241},
title = {Heart rate and its reduction in chronic heart failure and beyond},
url = {http://dx.doi.org/10.1002/ejhf.902},
volume = {19},
year = {2017}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Heart rate (HR) is associated with cardiovascular outcomes in all the stages of the cardiovascular continuum as well as in patients with pulmonary, cerebrovascular, and renal disease, sepsis, cancer, and erectile dysfunction. In patients with cardiovascular disease, but also in the general population, increased HR represents an important indicator of mortality with each acceleration of HR over 70 b.p.m. increasing the risk. In patients in sinus rhythm with chronic heart failure with reduced ejection fraction (HFrEF), a HR >70 b.p.m. increased the risk of hospitalization, and >75 b.p.m. the risk of cardiovascular death as shown in the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT). Reducing HR with ivabradine by 11 b.p.m. (placebocontrolled) reduced the primary composite endpoint (cardiovascular death and hospitalization for worsening heart failure). Ivabradine was well tolerated showing benefit irrespective of age or diabetes status, and also in the presence of low systolic blood pressure and severe heart failure (SHIFT trial). Therefore, HR qualifies as a modifiable risk factor in heart failure. In patients with stable coronary disease, HR is a risk marker but HR reduction with ivabradine does not improve outcomes. The role of selective HR lowering remains unclear in patients with pulmonary, renal, cerebrovascular, and other diseases, as the potential benefit of interventions on HR has not been explored in these conditions. Future studies should scrutinize if HR reduction improves outcomes, defining HR as a potential risk factor and therapeutic target in other conditions beyond heart failure.
AU  - Vukadinovic,AN
AU  - Vukadinovic,D
AU  - Borer,J
AU  - Cowie,M
AU  - Komajda,M
AU  - Lainscak,M
AU  - Swedberg,K
AU  - Boehm,M
DO  - 10.1002/ejhf.902
EP  - 1241
PY  - 2017///
SN  - 1388-9842
SP  - 1230
TI  - Heart rate and its reduction in chronic heart failure and beyond
T2  - European Journal of Heart Failure
UR  - http://dx.doi.org/10.1002/ejhf.902
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000412521000004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.902
VL  - 19
ER  -
Download