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How to consider target heart rate in patients with systolic heart failure

Toshihide Izumida1, Teruhiko Imamura1, Makiko Nakamura1

  • 1Second Department of Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama, 930-0194, Japan.

ESC Heart Failure
|June 28, 2020
PubMed

Insights

Optimizing heart rate in systolic heart failure patients using a novel formula based on echocardiography can improve cardiac output. This formula estimates ideal heart rate by minimizing E-wave and A-wave overlap.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Management

Background:

  • Heart rate reduction therapy, using ivabradine, is common for systolic heart failure.
  • The optimal target heart rate for these patients remains debated.
  • Echocardiographic E-wave and A-wave overlap may indicate ideal heart rate.

Purpose of the Study:

  • To assess the association between heart rate, deceleration time, and E-wave/A-wave overlap in systolic heart failure.
  • To develop a formula for estimating ideal heart rate that minimizes this overlap.

Main Methods:

  • Transthoracic echocardiography was performed on 368 systolic heart failure patients.
  • Multiple linear regression analyzed heart rate, deceleration time, and overlap length.
  • A formula was derived to estimate overlap and ideal heart rate.

Main Results:

  • A formula was developed: estimated overlap = -589 + 6.2 × heart rate + 0.81 × deceleration time (r=0.62).
  • The ideal heart rate formula is: ideal heart rate = 93 - 0.13 × deceleration time.
  • This suggests a method to personalize heart rate targets.

Conclusions:

  • A novel formula using deceleration time estimates ideal heart rate for systolic heart failure patients.
  • This formula aims to achieve zero E-wave/A-wave overlap, potentially maximizing cardiac output.
  • Further studies are needed to evaluate the prognostic impact of this formula-guided optimization.
Abstract

Keywords:
Deceleration timeEchocardiographyIvabradine

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