Resting Heart Rate in Cardiovascular Disease
Kim Fox, MD, FESC*,*,
Jeffrey S. Borer, MD, FACC ,
A. John Camm, MD, FESC, FACC ,
Nicolas Danchin, MD, FESC ,
Roberto Ferrari, MD, FESC||,
Jose L. Lopez Sendon, MD, FESC, FACC¶,
Philippe Gabriel Steg, MD, FESC, FACC#,
Jean-Claude Tardif, MD, FACC, FRCPC**,
Luigi Tavazzi, MD, FESC, FACC,
Michal Tendera, MD, FESC, FACC for the Heart Rate Working Group
* Royal Brompton Hospital, London, England
Weill Medical College of Cornell University, New York, New York
Division of Cardiac and Vascular Sciences, St. George's University of London, London, England
Hôpital Européen Georges Pompidou, Paris, France
|| Arcispedale S. Anna, Divisione di Cardiologia, University of Ferrara, Ferrara, Italy
¶ Hospital Universitario La Paz, Madrid, Spain
# Hôpital Bichat, Claude Bernard, Paris, France
** Montreal Heart Institute, Université de Montreal, Montreal, Canada
Department of Cardiology, Policlinico San Matteo, Institute of Care and Research, Pavia, Italy
Silesian School of Medicine, 3rd Division of Cardiology, Katowice, Poland
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Figure 1 Heart Rate and Mortality in Healthy Men
Relative risk of death from any cause, nonsudden death from myocardial infarction (MI), and sudden death from MI by quintiles of resting heart rate in 5,713 men without known or suspected heart disease. Reprinted with permission from Jouven et al. (1). bpm = beats/min.
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Figure 2 Heart Rate and Mortality in Coronary Artery Disease
Relationship between hazard ratio and resting heart rate for all-cause and cardiovascular mortality in 24,913 patients with suspected or proven coronary artery disease. Based on data from Diaz et al. (5). bpm = beats/min.
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Figure 3 Heart Rate Reduction and Mortality After Myocardial Infarction
Relationship between the mean reduction in heart rate and the mean change in mortality (relative to placebo) in different randomized, placebo-controlled trials of beta-blockers after myocardial infarction. The linear regression line (r = 0.6, p < 0.05) was fitted excluding the smallest study (open circles). Modified and based on data from Kjekshus (17). bpm = beats/min.
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Figure 4 Heart Rate Reduction and Myocardial Ischemia
Relationship between the improvement in time to myocardial ischemia during bicycle exercise and the reduction in exercise heart rate achieved in stable angina patients after treatment with 2 doses of 3 different calcium channel blockers (amlodipine, diltiazem, and mibefradil). Reprinted with permission from van der Vring et al. (22). bpm = beats/min.
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Figure 5 Heart Rate Reduction and Mortality in Heart Failure
Relationship between mean change in heart rate and mean change in mortality in studies of patients with chronic heart failure. Reprinted with permission from Kjekshus and Gullestad (23). ANZ = Australia/New Zealand Heart Failure Research Collaborative Group; BHAT = Beta Blocker Heart Attack Trial; bpm = beats/min; CIBIS = Cardiac Insufficiency Bisoprolol Study; CONSENSUS = Cooperative North Scandinavian Enalapril Survival Study; GEISCA = Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina; HDZ/ISDN = hydralazine/isosorbide dinitrate; MOCHA = Multicenter Oral Carvedilol Heart Failure Assessment; NOR TIMOLOL = Norwegian Multicentre Study Group; PROFILE = Prospective Randomized Flosequinan Longevity Evaluation; PROMISE = Protection Devices in PCI-Treatment of Myocardial Infarction for Salvage of Endangered Myocardium Study; SOLVD = Studies of Left Ventricular Dysfunction; US CARVEDILOL = U.S. Carvedilol Heart Failure Study Group; VHeFT = Vasodilator in Heart Failure Trials; XAMOTEROL = Xamoterol in Severe Heart Failure Study Group.
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