Holter-Derived Mean Heart Rate as a Predictor of Short-Term Clinical Risk in Patients Hospitalized With Acute Heart...

Area of Science:

• Cardiology
• Internal Medicine
• Critical Care Medicine

Background:

• Heart rate (HR) is a critical indicator of autonomic and hemodynamic stress in acute heart failure (AHF).
• The prognostic value of 24-hour Holter-derived mean HR for short-term outcomes during AHF hospitalization is not well-established.
• This study aimed to assess the association between Holter-derived mean HR and clinical outcomes in hospitalized AHF patients.

Purpose of the Study:

• To evaluate the predictive capability of 24-hour Holter-derived mean heart rate (HR) for short-term clinical outcomes in patients hospitalized with acute heart failure (AHF).
• To compare the prognostic value of continuous Holter-derived mean HR with single-time point admission HR measurements in AHF.

Main Methods:

• Consecutive adult patients hospitalized with AHF underwent 24-hour Holter monitoring during early hospitalization.
• Mean HR was categorized (< 70 bpm, 70-100 bpm, > 100 bpm).
• Outcomes included in-hospital mortality and 30, 60, 90-day post-discharge mortality and readmission. Statistical analyses evaluated associations between mean HR categories and outcomes.

Main Results:

• In-hospital mortality was significantly associated with mean HR, with higher rates in the > 100 bpm group (31.3%) compared to the < 70 bpm group (4.8%).
• A mean HR threshold > 100 bpm was a significant predictor of in-hospital mortality (P = 0.012).
• Admission HR alone did not predict mortality, and post-discharge outcomes did not significantly differ across HR categories.

Conclusions:

• Twenty-four-hour Holter-derived mean HR is a robust predictor of in-hospital mortality in AHF patients.
• Continuous Holter monitoring provides superior prognostic information compared to single HR measurements for in-hospital outcomes in AHF.
• Findings suggest potential utility in perioperative risk assessment for AHF patients, warranting further investigation in surgical cohorts.