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European Journal of Heart Failure 2007 9(9):962; doi:10.1016/j.ejheart.2007.06.006
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© 2007 European Society of Cardiology

Letters to the Editor

John Kjekshus

Department of Cardiology,Rikshospitalet University Hospital, University of Oslo Norway Tel.: +47 2307 0946.

E-mail address: john.kjekshus{at}medisin.uio.no

Received April 13, 2007; Dear Sir,

Increased resting heart rate is inversely associated with life expectancy [1]. Heart rate reduction with beta-blocker treatment has been shown to confer survival benefit in patients with coronary heart disease [2,3]. Daniela Dobre et al. [4] observed that beta-blocker treatment in patients with heart failure and preserved ejection fraction reduce mortality by 43%. They refer to a reduction in heart rate as a possible mechanism of benefit. Baseline average heart rate in their study was quite high, 97.6 beats per minute with a large potential for reduction. The high resting heart rate is associated with poor prognosis and benefit might be expected with heart rate reduction if cardiac output can be maintained. The information on heart rate reduction and survival benefit in heart failure trials is limited. Daniela Dobre and co-workers should provide data on changes in heart rate or blood pressure, which is crucial in understanding the clinical implications of beta-blocker treatment. The information may also be supportive of heart rate reduction as their proposed mode of action. The use of high and low doses of the beta-blockers also warrants some information on the respective changes in resting heart rates among these patients.

Yours faithfully

John Kjekshus


   References
Top
 References
 

  1. Levine H.J. Rest heart rate and life expectancy. J Am Coll Cardiol (1997) 30(4):1104–1106.[Abstract]
  2. Gundersen T., Grøttum P., Pedersen T., Kjekshus J.K. Effect of Timolol on mortality and reinfarction after acute myocardial infarction: prognostic importance of heart rate at rest. Am J Cardiol (1986) 58:20–24.[CrossRef][Web of Science][Medline]
  3. Kjekshus J. Heart rate — a mechanism of benefit. Eur Heart J (1988) 9(Supplement_A):115–122.[Abstract/Free Full Text]
  4. Dobre D., van Veldhuisen D.J., DeJongste M.J.L., Lucas C., Cleuren G., Sanderman R., et al. Prescription of beta-blockers in patients with advanced heart failure and preserved left ventricular ejection fraction. Clinical implications and survival. Eur J Heart Fail (2007) 9:280–286.[Abstract/Free Full Text]

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This Article
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Right arrow FREE Full Text (PDF) Freely available
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