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Optimal Heart Rate and Prognosis in Patients with Cardiac Amyloidosis

Toshihide Izumida1, Teruhiko Imamura1, Makiko Nakamura1

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

Journal of Cardiovascular Development and Disease
|December 23, 2021
PubMed

Insights

Determining the ideal heart rate (HR) is crucial for patients with cardiac amyloidosis. This study suggests that an optimal HR is linked to better clinical outcomes, warranting further investigation into HR management.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Amyloidosis Research

Background:

  • The optimal heart rate (HR) for maximizing cardiac output and improving clinical outcomes in cardiac amyloidosis patients is not well-defined.
  • Cardiac amyloidosis is a progressive condition affecting heart function.

Purpose of the Study:

  • To investigate the association between an individually calculated optimal heart rate and clinical outcomes in patients with cardiac amyloidosis.
  • To determine if achieving an optimal heart rate impacts cardiac death or heart failure readmission rates.

Main Methods:

  • Retrospective analysis of consecutive patients diagnosed with cardiac amyloidosis and in sinus rhythm.
  • Calculation of ideal HR based on trans-mitral flow echocardiography to ensure adjacent E-wave and A-wave.
  • Investigation of the relationship between optimal HR and adverse cardiovascular events.

Main Results:

  • Ten patients (median age 74, 80% male) were included in the study.
  • The median actual HR was 64 bpm, while the median ideal HR was 69 bpm.
  • A trend towards higher event rates (cardiac death or heart failure readmission) was observed in patients with sub-optimal HR compared to those with optimal HR.

Conclusions:

  • An optimal heart rate appears to be associated with improved clinical outcomes in patients with cardiac amyloidosis.
  • Further research is needed to explore the clinical implications and effectiveness of aggressive HR optimization strategies in this patient population.
Abstract

Keywords:
cardiac amyloidosishemodynamicsivabradine

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