Effect of heart rate control on mortality and functional class in patients with heart failure

Background Resting heart rate (HR) is an independent predictor of all-cause and cardiovascular mortality in patients with left ventricular dysfunction. No studies have been conducted on the impact of HR on mortality and functional class in patients with heart failure (HF). Objectives Evaluate the effect of HR less than 70 beats per minute (bpm) on functional class and mortality among patients with left ventricular systolic HF. Methodology A retrospective, descriptive study, analyzed data on 868 eligible patients with HF and ejection fraction (EF) ⩽ 40%, attending the Cardiovascular Disease Management Program, King Abdulaziz Cardiac Center, between April 2000 and October 2011. Patients were divided into group A (HR  n  = 433, and group B (HR ⩾ 70 bpm) n  = 435. New York Heart Association (NYHA) was used to assess functional capacity. Last follow-up data, from an electronic database, was analyzed using SPSS. Results Group A had mean age 62.4 years, 20% female with mean HR 63 bpm. Group B had mean age 59.5 years, 27% female with mean HR 78 bpm. EF (30.9%) and other co-morbidities (71% diabetic, 70% hypertensive) were similar between groups. All cause mortality in total population ( n  = 868) was 6% (5.8% group A, 6.2% group B ( P There was no statistical significance between the two groups in respect to NYHA functional class. Conclusions Findings did not support the hypothesis that HR is an independent predictor of all-cause mortality, in this patient population. Future prospective studies are strongly recommended.