TY - JOUR
T1 - How Heart Rate Should Be Controlled in Patients with Atherosclerosis and Heart Failure
AU - da Silva, Rose Mary Ferreira Lisboa
AU - Borges, Anaisa Silva Roever
AU - Silva, Nilson Penha
AU - Resende, Elmiro Santos
AU - Tse, Gary
AU - Liu, Tong
AU - Roever, Leonardo
AU - Biondi-Zoccai, Giuseppe
N1 - Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Purpose of Review: Resting heart rate is an independent risk factor for all-cause and cardiovascular mortality in patients with heart failure. The main objectives are to discuss the prognosis of heart rate, its association with coronary atherosclerosis, and the modalities of control of the heart rate in sinus rhythm and in the rhythm of atrial fibrillation in patients with chronic heart failure. Recent Findings: As a therapeutic option for control heart rate, medications such as beta-blockers, digoxin, and finally ivabradine have been studied. Non-dihydropyridine calcium channel blockers are contraindicated in patients with heart failure and reduced ejection fraction. The influence of the magnitude of heart rate reduction and beta-blocker dose on morbidity and mortality will be discussed. Regarding the patients with heart failure and atrial fibrillation, there are different findings in heart rate control with the use of a beta-blocker. Patients eligible for ivabradine have clinical benefits and increased ejection fraction. Vagal nerve stimulation has low efficacy for the control of heart rate. Complementary therapies such as tai chi and yoga showed no effect on heart rate. Summary: In this review, we discuss the main therapeutic options for the control of heart rate in patients with atherosclerosis and heart failure. More research is needed to examine the effects of therapeutic options for heart rate control in different population types, as well as their effects on clinical outcomes and impact on morbidity and mortality.
AB - Purpose of Review: Resting heart rate is an independent risk factor for all-cause and cardiovascular mortality in patients with heart failure. The main objectives are to discuss the prognosis of heart rate, its association with coronary atherosclerosis, and the modalities of control of the heart rate in sinus rhythm and in the rhythm of atrial fibrillation in patients with chronic heart failure. Recent Findings: As a therapeutic option for control heart rate, medications such as beta-blockers, digoxin, and finally ivabradine have been studied. Non-dihydropyridine calcium channel blockers are contraindicated in patients with heart failure and reduced ejection fraction. The influence of the magnitude of heart rate reduction and beta-blocker dose on morbidity and mortality will be discussed. Regarding the patients with heart failure and atrial fibrillation, there are different findings in heart rate control with the use of a beta-blocker. Patients eligible for ivabradine have clinical benefits and increased ejection fraction. Vagal nerve stimulation has low efficacy for the control of heart rate. Complementary therapies such as tai chi and yoga showed no effect on heart rate. Summary: In this review, we discuss the main therapeutic options for the control of heart rate in patients with atherosclerosis and heart failure. More research is needed to examine the effects of therapeutic options for heart rate control in different population types, as well as their effects on clinical outcomes and impact on morbidity and mortality.
KW - Beta-blocker
KW - Heart rate
KW - Ivabradine
KW - Mortality
KW - Systolic heart failure
UR - http://www.scopus.com/inward/record.url?scp=85053380166&partnerID=8YFLogxK
U2 - 10.1007/s11883-018-0757-3
DO - 10.1007/s11883-018-0757-3
M3 - Review article
C2 - 30225613
AN - SCOPUS:85053380166
SN - 1523-3804
VL - 20
JO - Current Atherosclerosis Reports
JF - Current Atherosclerosis Reports
IS - 11
M1 - 54
ER -