Imperial College London
Alternate

ProfessorDudleyPennell

Faculty of Medicine, National Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7351 8810d.pennell

 
 
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Location

 

CMR UnitRoyal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Halliday:2021:10.1016/j.jchf.2021.03.010,
author = {Halliday, B and Vazir, A and Owen, R and Gregson, J and Wassall, R and Lota, A and Khalique, Z and Tayal, U and Jones, R and Hammersley, D and Pantazis, A and Baksi, A and Rosen, S and Pennell, D and Cowie, M and Cleland, J and Prasad, S},
doi = {10.1016/j.jchf.2021.03.010},
journal = {JACC: Heart Failure},
pages = {509--517},
title = {Heart rate as a marker of relapse during withdrawal of therapy in recovered dilated cardiomyopathy},
url = {http://dx.doi.org/10.1016/j.jchf.2021.03.010},
volume = {9},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: To determine the relationship between heart rate and relapse amongst patients in the TRED-HF trial. Background: Understanding markers and mechanisms of relapse amongst patients with recovered dilated cardiomyopathy (DCM) might enable personalised management.Methods: The relationship between serial heart rate measurements and relapse was examined amongst patients TRED-HF, a randomised trial which examined the safety and feasibility of withdrawing heart failure therapy amongst 51 patients with recovered DCM over 6 months. In total, 25 patients were randomised to therapy withdrawal and 26 to continue therapy, of whom 25 subsequently began therapy withdrawal in a single arm crossover phase.Results: The mean heart rate (standard deviation) for those who had therapy withdrawn and did not relapse was 64.6bpm (10.7) at baseline and 74.7bpm (10.4) at follow-up compared to 68.3bpm (11.3) and 86.1bpm (11.8) for those who relapsed.  After adjusting for baseline heart rate, patients who had therapy withdrawn and relapsed had a 10.4bpm (95% confidence intervals [CIs] 4.0-16.8) greater rise in heart rate compared to patients who had therapy withdrawn and did not relapse (p=0.002). After adjusting for age, log NT-pro-BNP and LVEF, heart rate (per 10bpm - hazard ratio: 1.65, 95%CI 1.10-2.57, p=0.01) and change in heart rate from baseline (per 10bpm - hazard ratio: 1.70, 95%CI 1.12-2.57, p=0.01) were associated with relapse. The results remained qualitatively the same after adjusting for beta-blocker dose.Conclusion: For patients with DCM and improved LVEF, the rise in heart rate after withdrawing treatment identifies patients who are more likely to relapse. Whether the increase in heart rate is a marker or mediator of relapse requires investigation.
AU  - Halliday,B
AU  - Vazir,A
AU  - Owen,R
AU  - Gregson,J
AU  - Wassall,R
AU  - Lota,A
AU  - Khalique,Z
AU  - Tayal,U
AU  - Jones,R
AU  - Hammersley,D
AU  - Pantazis,A
AU  - Baksi,A
AU  - Rosen,S
AU  - Pennell,D
AU  - Cowie,M
AU  - Cleland,J
AU  - Prasad,S
DO  - 10.1016/j.jchf.2021.03.010
EP  - 517
PY  - 2021///
SN  - 2213-1779
SP  - 509
TI  - Heart rate as a marker of relapse during withdrawal of therapy in recovered dilated cardiomyopathy
T2  - JACC: Heart Failure
UR  - http://dx.doi.org/10.1016/j.jchf.2021.03.010
UR  - https://www.sciencedirect.com/science/article/pii/S2213177921001785?via%3Dihub
UR  - http://hdl.handle.net/10044/1/88621
VL  - 9
ER  -
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