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Heart rate: an accessible risk indicator in adult congenital heart disease

Paul M Hendriks1, Annemien E van den Bosch1, Jan A Kors2

  • 1Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, Rotterdam, Netherlands.

Heart (British Cardiac Society)
|November 23, 2023
PubMed

Insights

Higher resting heart rate is linked to worse outcomes in adults with congenital heart disease (ACHD). This study found increased mortality and heart failure risk with higher heart rates in ACHD patients.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease (ACHD) Research

Background:

  • Elevated resting heart rate is a known risk factor for adverse outcomes in general and cardiovascular populations.
  • The prognostic significance of resting heart rate in Adult Congenital Heart Disease (ACHD) requires further investigation.

Purpose of the Study:

  • To assess the association between resting heart rate and adverse outcomes in patients with moderate or complex ACHD.

Main Methods:

  • Prospective observational cohort study including 556 ACHD patients.
  • Resting 12-lead ECGs were used to determine heart rate via the Modular ECG Analysis System (MEANS).
  • Primary endpoint: all-cause mortality; Secondary endpoint: composite of mortality and heart failure. Survival analysis utilized Kaplan-Meier and Cox proportional hazards models.

Main Results:

  • A total of 556 patients (median age 32 years) were included, with a mean heart rate of 69±13 bpm.
  • Over a median follow-up of 10.1 years, 6.5% died and 14.9% reached the secondary endpoint.
  • Higher heart rates were significantly associated with lower survival and heart failure-free survival, even after adjusting for clinical factors (Mortality HR 1.57 per 10 bpm; Mortality/HF HR 1.33 per 10 bpm).

Conclusions:

  • Resting heart rate is a significant independent predictor of mortality and heart failure in ACHD patients.
  • Elevated heart rate identifies individuals at higher risk within the ACHD population.
Abstract

Keywords:
ElectrocardiographyHeart Defects, CongenitalRisk Factors

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