title: Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis).
abstract: OBJECTIVE
  The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction.
  
  
  BACKGROUND
  The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population.
  
  
  METHODS
  Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate.
  
  
  RESULTS
  Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model.
  
  
  CONCLUSIONS
  Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487).
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland; Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Opdahl
authors.affiliation: Department of Radiology, Mount Sinai School of Medicine, New York, New York.
authors.forename: Bharath
authors.initials: B
authors.lastname: Ambale Venkatesh
authors.affiliation: Department of Radiology, Mount Sinai School of Medicine, New York, New York.
authors.forename: Veronica R S
authors.initials: VRS
authors.lastname: Fernandes
authors.affiliation: Offices of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
authors.forename: Colin O
authors.initials: CO
authors.lastname: Wu
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Andre L C
authors.initials: ALC
authors.lastname: Almeida
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Boaz
authors.initials: B
authors.lastname: Rosen
authors.affiliation: School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Benilton
authors.initials: B
authors.lastname: Carvalho
authors.affiliation: Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.affiliation: National Institute for Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Cardiology Division, Johns Hopkins University, Baltimore, Maryland; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: jlima@jhmi.edu.
authors.forename: João A C
authors.initials: JAC
authors.lastname: Lima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data; D012146:Rest / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology*
keywords: cardiac MRI; coronary heart disease; heart failure; left ventricular dysfunction; myocardial strain; resting heart rate