title: Differential prognostic impact of resting heart rate in older compared with younger patients with chronic heart failure--insights from TIME-CHF.
abstract: BACKGROUND
  There is little information regarding the prognostic role of resting heart rate (HR) in older compared with younger patients with chronic heart failure (HF).
  
  
  RESULTS
  In patients enrolled in the Trial of Intensified Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) with sinus rhythm, effects of baseline HR (≥70 vs <70 beats/min [bpm]) on 18-month outcomes were compared between older (≥75 years; n = 186) and younger (<75 years; n = 141) patients. Older patients with lower (61 ± 6 bpm) and higher (83 ± 9 bpm) HR had similar left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) functional class, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and survival and HF hospitalization-free survival. In contrast, younger patients with higher HR (81 ± 7 bpm) had higher NT-proBNP and NYHA functional class, lower LVEF, and a higher risk of death (hazard ratio 4.01 [95% confidence interval (CI) 1.17 -13.69]; P = .02) and death or HF hospitalization (hazard ratio 2.35 [95% CI 1.01-5.50]; P = .04) than those with lower HR (62 ± 5 bpm), with the association between higher HR and survival remaining significant after adjustment for NYHA functional class, LVEF, and NT-proBNP.
  
  
  CONCLUSIONS
  In contrast to HF patients aged <75 years, we found no association between HR and worse outcomes in HF patients aged ≥75 years.
authors.affiliation: Department of Cardiology, Kantonsspital, St Gallen, Switzerland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Zurek
authors.affiliation: Department of Cardiology, Kantonsspital, St Gallen, Switzerland; Department of Cardiology, University Hospital, Basel, Switzerland. Electronic address: micha.maeder@kssg.ch.
authors.forename: Micha T
authors.initials: MT
authors.lastname: Maeder
authors.affiliation: Department of Cardiology, Kantonsspital, St Gallen, Switzerland.
authors.forename: Hans
authors.initials: H
authors.lastname: Rickli
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland; Cardiocentro, Lugano, Switzerland.
authors.forename: Stefano
authors.initials: S
authors.lastname: Muzzarelli
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sanders-van Wijk
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland; Department of Cardiology, Kantonsspital, Frauenfeld, Switzerland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Abbühl
authors.affiliation: Department of Cardiology, Kantonsspital, Baselland Bruderholz, Switzerland.
authors.forename: Rolf
authors.initials: R
authors.lastname: Handschin
authors.affiliation: Department of Cardiology, Kantonsspital, Luzern, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Jeker
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Pfisterer
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Brunner-la Rocca
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011379:Prognosis; D012146:Rest / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Heart rate; TIME-CHF; age; chronic heart failure; prognosis