The Effect of Heart Rate on Quality of Life in Patients with Chronic Heart Failure
https://doi.org/10.52420/umj.24.1.59
EDN: MVHVRU
Abstract
Introduction. Chronic heart failure (CHF) leads to a steady deterioration in the quality of life (QOL) and a decrease in exercise tolerance of patients. Numerous studies have confirmed the role of increased heart rate in worsening the prognosis of CHF — heart rate more than 75 bpm needs reduction to optimize the clinical status of patients.
The purpose of the study is to analyze the effect of heart rate on QOL and exercise tolerance in patients with CHF with a low left ventricular ejection fraction.
Materials and methods. A prospective comparative study was conducted. 80 patients (54 men and 26 women, verage age — (66.3±7.9) years) with postinfarction cardiosclerosis and sinus rhythm, with CHF II–III NYHA functional classes with an ejection fraction less than 40 % were examined.
Results. Significantly better QOL indicators were noted in patients with heart rate 60–69 bpm. The lowest indicators of functional activity were noted at 55–59 bpm, and socio-psychological activity at 70–75 bpm. Exercise tolerance is higher in patients with a heart rate of 60–69 bpm, its lowest rates were noted at 70–75 bpm.
Discussion. The optimal heart rate range determination in patients with postinfarction cardiosclerosis and CHF allows targeted titration of the β-blocker dosage, achieving an improvement in QOL and the clinical and functional status of patients.
Conclusion. In patients with CHF careful selection of β-blockers and ivabradine therapy demonstrates the most optimal indicators of physical activity and QOL with a heart rate of 60–64 bpm and 65–69 bpm.
About the Authors
E. B. Vakhitova
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ekaterina B. Vakhitova — Assistant of the Department of Hospital Therapy
Ekaterinburg
Competing Interests:
Oksana M. Khromtsova is Editorial Council member of Ural Medical Journal, and she did not participate in reviewing the material or making a decision about its publication. The other authors declare the absence of obvious or potential conflicts of interest.
O. M. Khromtsova
Ural State Medical University;
Central City Hospital No. 7
Russian Federation
Competing Interests:
Russian Federation
Oksana M. Khromtsova — Doctor of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Hospital Therapy;
Consultant of the Therapeutic Clinic
Ekaterinburg
Competing Interests:
Oksana M. Khromtsova is Editorial Council member of Ural Medical Journal, and she did not participate in reviewing the material or making a decision about its publication. The other authors declare the absence of obvious or potential conflicts of interest.
M. V. Arkhipov
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Michail V. Arkhipov — Doctor of Sciences (Medicine), Professor, Professor of the Department of Polyclinical Therapy
Ekaterinburg
Competing Interests:
Oksana M. Khromtsova is Editorial Council member of Ural Medical Journal, and she did not participate in reviewing the material or making a decision about its publication. The other authors declare the absence of obvious or potential conflicts of interest.
Ya. G. Bozhko
Ural State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yakov G. Bozhko — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Polyclinical Therapy
Ekaterinburg
Competing Interests:
Oksana M. Khromtsova is Editorial Council member of Ural Medical Journal, and she did not participate in reviewing the material or making a decision about its publication. The other authors declare the absence of obvious or potential conflicts of interest.
References
1. Afifi MM, Cherniaev IA. Economics and demography in the fight against cardiovascular disease: A cross-country analysis. USMU Medical Bulletin. 2024;(4):27–42. (In Russ.). EDN: https://elibrary.ru/DQHQNQ.
2. Groenewegen A, Rutten FH, Mosterd A, Hoes AW. Epidemiology of heart failure. European Journal of Heart Failure. 2020;22(8):1342–1356. DOI: https://doi.org/10.1002/ejhf.1858.
3. Polyakov DS, Fomin IV, Belenkov YN, Mareev VY, Ageev FT, Artemjeva EG, et al. Chronic heart failure in the Russian Federation: What has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14. (In Russ., Eng.). DOI: https://doi.org/10.18087/cardio.2021.4.n1628.
4. Kovalenko VN, Voronkov LG. The problem of the quality of life in chronic heart failure. Eurasian Heart Journal. 2012;(1):49–56. (In Russ.). DOI: https://doi.org/10.38109/2225-1685-2012-1-49-56.
5. Bilbao A, Escobar A, García-Perez L, Navarro G, Quirós R. The Minnesota living with heart failure questionnaire: Comparison of different factor structures. Health Quality Life Outcomes. 2016;14:23. DOI: https://doi.org/10.1186/s12955-016-0425-7.
6. McAlister FA, Wiebe N, Ezekowitz JA, Leung AA, Armstrong PW. Meta-analysis: Beta-blocker dose, heart rate reduction, and death in patients with heart failure. Annals of Internal Medicine. 2009;150(11):784–794. DOI: https://doi.org/10.7326/0003-4819-150-11-200906020-00006.
7. Kuznetsov DP, Aretinskiy VB, Grishina IF, Isupov AB. Features of psychological status in patients with coronary heart disease after coronary bypass. Ural Medical Journal. 2018;(12):55–59. (In Russ.). EDN: https://www.elibrary.ru/saxhlb.
8. Kurgansky KE, Schubert P, Parker R, Djousse L, Riebman JB, Gagnon DR, et al. Association of pulse rate with outcomes in heart failure with reduced ejection fraction: A retrospective cohort study. BMC Cardiovasc Disorders. 2020;20(1):92. DOI: https://doi.org/10.1186/s12872-020-01384-6.
9. Levitan EB, Van Dyke MK, Loop MS, O’Beirne R, Safford MM. Barriers to beta-blocker use and up-titration among patients with heart failure with reduced ejection fraction. Cardiovasc Drugs and Therapy. 2017; 31(5–6):559–564. DOI: https://doi.org/10.1007/s10557-017-6764-8.
10. Baranskaya LT, Yemelyanova LA, Grigorova NE. Motivational and semantic component of internal pigture of disease in patients with ischemic heart disease. Ural Medical Journal. 2018;(12):42–49. (In Russ.). EDN: https://www.elibrary.ru/gathhh.
11. Ameri P, Bertero E, Maack C, Teerlink JR, Rosano G, Metra M. Medical treatment of heart failure with reduced ejection fraction: The dawn of a new era of personalized treatment? European Heart Journal — Cardiovascular Pharmacotherapy. 2021;7(6):539–546. DOI: https://doi.org/10.1093/ehjcvp/pvab033.
12. Grande D, Iacoviello M, Aspromonte N. The effects of heart rate control in chronic heart failure with reduced ejection fraction. Heart Failure Reviews. 2018;23(4):527–535. DOI: https://doi.org/10.1007/s10741-018-9704-1.
13. Izumida T, Imamura T, Ueno Y, Tanaka S, Kataoka N, Nakamura M, et al. Impact of optimal heart rate on left ventricular reverse remodeling and functional improvement in patients with systolic heart failure. Heart and Vessels. 2021;36(11):1688–1693. DOI: https://doi.org/10.1007/s00380-021-01864-5.
14. Lan WR, Lin SI, Liao FC, Chang HY, Tsai CT, Wu YJ, et al. Effect of reducing heart rate on outcomes in patients with reduced ejection fraction. The American Journal of Cardiology. 2021;150:77–81. DOI: https://doi.org/10.1016/j.amjcard.2021.03.050.
15. Abdin A, Anker SD, Cowie MR, Filippatos GS, Ponikowski P, Tavazzi L, et al. Associations between baseline heart rate and blood pressure and time to events in heart failure with reduced ejection fraction patients: Data from the QUALIFY international registry. European Journal of Heart Failure. 2023;25(11):1985–1993. DOI: https://doi.org/10.1002/ejhf.3023.
16. Gomes BFO, Benchimol-Barbosa PR, Nadal J. Predictive model of all-cause death in patients with heart failure using heart rate variability. Arquivos Brasileiros de Cardiologia. 2023;120(11): e20220379. (In Port., Eng.). DOI: https://doi.org/10.36660/abc.20220379.
17. Joo SJ, Kim SY, Choi JH, Park HK, Beom JW, Lee JG, et al. Effect of beta-blocker therapy in patients with or without left ventricular systolic dysfunction after acute myocardial infarction. European Heart Journal — Cardiovascular Pharmacotherapy. 2021;7(6):475–482. DOI: https://doi.org/10.1093/ehjcvp/pvaa029.
18. Tolmacheva AA, Lozhkina NG, Kozik VA, Khasanova MH, Stafeeva EA, Naydena EA, et al. Evolution of chronic heart failure syndrome in a patient with myocardial. Ural Medical Journal. 2018;(7):79–82. (In Russ.). EDN: https://www.elibrary.ru/ymrewd.
19. Garganeeva AA, Aleksandrenko VA, Kuzheleva EA, Rebrova TY. Beta-adrenergic reactivity of erythrocytes and the progression of heart failure in patients after myocardial infarction. Russian Journal of Cardiology. 2020;25(1):3407. (In Russ.). DOI: https://doi.org/10.15829/1560-4071-2020-1-3407.
20. Cullington D, Goode KM, Zhang J, Cleland JGF, Clark AL. Is heart rate important for patients with heart failure in atrial fibrillation? JACC: Heart Failure. 2014;2(3):213–220. DOI: https://doi.org/10.1016/j.jchf.2014.01.005.
21. Li SJ, Sartipy U, Lund LH, Dahlström U, Adiels M, Petzold M, et al. Prognostic significance of resting heart rate and use of β-blockers in atrial fibrillation and sinus rhythm in patients with heart failure and reduced ejection fraction: Findings from the Swedish heart failure registry. Circulation: Heart Failure. 2015;8(5): 871–879. DOI: https://doi.org/10.1161/circheartfailure.115.002285.
22. Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R; BEAUTIFUL Investigators. Relationship between ivabradine treatment and cardiovascular outcomes in patients with stable coronary artery disease and left ventricular systolic dysfunction with limiting angina: A subgroup analysis of the randomized, controlled BEAUTIFUL trial. European Heart Journal. 2009;30(19):2337–2345. DOI: https://doi.org/10.1093/eurheartj/ehp358.
23. Böhm M, Komajda M, Borer JS, Ford I, Maack C, Tavazzi L, et al.; SHIFT Investigators. Duration of chronic heart failure affects outcomes with preserved effects of heart rate reduction with ivabradine: Findings from SHIFT. European Journal of Heart Failure. 2018;20(2):373–381. DOI: https://doi.org/10.1002/ejhf.1021.
24. Thackray SD, Ghosh JM, Wright GA, Witte KK, Nikitin NP, Kaye GC, et al. The effect of altering heart rate on ventricular function in patients with heart failure treated with beta-blockers. American Heart Journal. 2006;152(4):713.e9–713.e13. DOI: https://doi.org/10.1016/j.ahj.2006.07.007.
25. Dharod A, Soliman EZ, Dawood F, Chen H, Shea S, Nazarian S, et al; MESA Investigators. Association of asymptomatic bradycardia with incident cardiovascular disease and mortality: The Multi-Ethnic Study of Atherosclerosis (MESA). JAMA Internal Medicine. 2016;176(2):219–227. DOI: https://doi.org/10.1001/jamainternmed.2015.7655.
Review
For citations:
Vakhitova EB, Khromtsova OM, Arkhipov MV, Bozhko YG. The Effect of Heart Rate on Quality of Life in Patients with Chronic Heart Failure. Ural Medical Journal. 2025;24(1):59–69. (In Russ.) https://doi.org/10.52420/umj.24.1.59. EDN: MVHVRU
Views:
152
Email this article 