Heart rate: a prognostic factor and therapeutic target in chronic heart failure. The distinct roles of drugs with heart rate-lowering properties.
Heart rate not only predicts outcome but may also be a therapeutic target in patients with chronic heart failure. Several classes of pharmacological agents can be used to modulate heart rate, including beta-blockers, ivabradine, digoxin, amiodarone, and verapamil. Choice of agent will depend on heart rhythm, co-morbidities, and disease phenotype. Beneficial and harmful interactions may also exist. The aim of this paper is to summarize the current body of knowledge regarding the relevance of heart rate as a prognostic factor (risk marker) and particularly as a therapeutic target (risk factor) in patients with chronic heart failure, with a special focus on ivabradine, a novel agent that is currently the only available purely bradycardic agent.
INSERM, Center of Clinical Investigation 9501, Institut Lorrain du Coeur et des Vaisseaux, CHU Nancy, Université de Lorraine, Nancy, France.
Daniela
D
Dobre
Jeffrey S
JS
Borer
Kim
K
Fox
Karl
K
Swedberg
Kirkwood F
KF
Adams
John G F
JG
Cleland
Alain
A
Cohen-Solal
Mihai
M
Gheorghiade
Francois
F
Gueyffier
Christopher M
CM
O'Connor
Mona
M
Fiuzat
Athul
A
Patak
Ileana L
IL
Piña
Giuseppe
G
Rosano
Hani N
HN
Sabbah
Luigi
L
Tavazzi
Faiez
F
Zannad
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D011379:Prognosis
D000319:Adrenergic beta-Antagonists
Amiodarone; Beta‐blockers; Chronic heart failure; Digoxin; Heart rate; Heart rate‐lowering drugs; Ivabradine; Verapamil