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Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis).
J Am Coll Cardiol 2014; 63(12):1182-1189JACC

Abstract

OBJECTIVES

The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction.

BACKGROUND

The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population.

METHODS

Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate.

RESULTS

Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model.

CONCLUSIONS

Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487).

Authors+Show Affiliations

Cardiology Division, Johns Hopkins University, Baltimore, Maryland; Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.Department of Radiology, Mount Sinai School of Medicine, New York, New York.Department of Radiology, Mount Sinai School of Medicine, New York, New York.Offices of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland.Cardiology Division, Johns Hopkins University, Baltimore, Maryland.Cardiology Division, Johns Hopkins University, Baltimore, Maryland.Cardiology Division, Johns Hopkins University, Baltimore, Maryland.Cardiology Division, Johns Hopkins University, Baltimore, Maryland.School of Public Health, Johns Hopkins University, Baltimore, Maryland.Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.National Institute for Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland.Cardiology Division, Johns Hopkins University, Baltimore, Maryland; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: jlima@jhmi.edu.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

24412444

Citation

Opdahl, Anders, et al. "Resting Heart Rate as Predictor for Left Ventricular Dysfunction and Heart Failure: MESA (Multi-Ethnic Study of Atherosclerosis)." Journal of the American College of Cardiology, vol. 63, no. 12, 2014, pp. 1182-1189.
Opdahl A, Ambale Venkatesh B, Fernandes VRS, et al. Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2014;63(12):1182-1189.
Opdahl, A., Ambale Venkatesh, B., Fernandes, V. R. S., Wu, C. O., Nasir, K., Choi, E. Y., ... Lima, J. A. C. (2014). Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis). Journal of the American College of Cardiology, 63(12), pp. 1182-1189. doi:10.1016/j.jacc.2013.11.027.
Opdahl A, et al. Resting Heart Rate as Predictor for Left Ventricular Dysfunction and Heart Failure: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2014 Apr 1;63(12):1182-1189. PubMed PMID: 24412444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis). AU - Opdahl,Anders, AU - Ambale Venkatesh,Bharath, AU - Fernandes,Veronica R S, AU - Wu,Colin O, AU - Nasir,Khurram, AU - Choi,Eui-Young, AU - Almeida,Andre L C, AU - Rosen,Boaz, AU - Carvalho,Benilton, AU - Edvardsen,Thor, AU - Bluemke,David A, AU - Lima,João A C, Y1 - 2014/01/08/ PY - 2013/08/20/received PY - 2013/10/15/revised PY - 2013/11/25/accepted PY - 2014/1/14/entrez PY - 2014/1/15/pubmed PY - 2014/6/6/medline KW - cardiac MRI KW - coronary heart disease KW - heart failure KW - left ventricular dysfunction KW - myocardial strain KW - resting heart rate SP - 1182 EP - 1189 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 63 IS - 12 N2 - OBJECTIVES: The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction. BACKGROUND: The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population. METHODS: Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate. RESULTS: Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model. CONCLUSIONS: Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/24412444/Resting_heart_rate_as_predictor_for_left_ventricular_dysfunction_and_heart_failure:_MESA__Multi_Ethnic_Study_of_Atherosclerosis__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(13)06356-0 DB - PRIME DP - Unbound Medicine ER -