title: Prognostic relevance of heart rate at rest for survival and the quality of life in patients with dilated cardiomyopathy.
abstract: OBJECTIVE
  Reduction of resting heart rate (HR) has been suggested as a novel therapeutic approach in patients with chronic heart failure because it has been shown to prolong survival and also to improve health-related quality of life (Hr-QoL). The purpose of this analysis was to assess the prognostic impact of resting HR in patients with dilated cardiomyopathy (DCM).
  
  
  METHODS
  217 patients with DCM confirmed by endomyocardial biopsy were investigated (age 49 ± 11 years, 20.7 % were female). The study population was divided into two groups according to the median of the resting HR. After a median follow-up time of 7.4 years overall survival and health-related quality of life (Hr-QoL) were compared in both groups. Survival was compared using Kaplan-Meier method and Hr-QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
  
  
  RESULTS
  Elevated resting HR was associated with poor 1-year survival (p = 0.03). In contrast, long-term survival was not affected by HR (p = 0.20). Patients with lower HR at rest scored significantly lower on the MLHFQ (20 vs. 36, p = 0.03), indicating that higher resting HR is associated with an impairment of Hr-QoL.
  
  
  CONCLUSIONS
  Increased HR might be used as a diagnostic tool to identify patients at risk. Reduction of resting HR in patients with DCM might be a therapeutic option to improve Hr-QoL and therefore merits further investigation in future studies.
authors.affiliation: Clinic of Internal Medicine I, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Buntaro
authors.initials: B
authors.lastname: Fujita
authors.forename: Marcus
authors.initials: M
authors.lastname: Franz
authors.forename: Bjoern
authors.initials: B
authors.lastname: Goebel
authors.forename: Michael
authors.initials: M
authors.lastname: Fritzenwanger
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Kuethe
authors.forename: Markus
authors.initials: M
authors.lastname: Ferrari
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate