Resting Heart Rate as Predictor for Left Ventricular Dysfunction and Heart Failure: MESA (Multi-Ethnic Study of Atherosclerosis)

• Published in: Journal of the American College of Cardiology Vol. 63; no. 12; pp. 1182 - 1189
• Main Authors: OPDAHL, Anders, BHARATH AMBALE VENKATESH, BLUEMKE, David A, LIMA, Joao A. C, FERNANDES, Veronica R. S, WU, Colin O, NASIR, Khurram, CHOI, Eui-Young, ALMEIDA, Andre L. C, ROSEN, Boaz, CARVALHO, Benilton, EDVARDSEN, Thor
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier 01-04-2014
• Subjects: Aged; Aged, 80 and over; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Continental Population Groups - statistics & numerical data; Coronary Disease - epidemiology; Diabetes Mellitus - epidemiology; Female; Follow-Up Studies; Heart; Heart Failure - epidemiology; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Rate - physiology; Heart Ventricles - pathology; Humans; Hypertension - epidemiology; Linear Models; Magnetic Resonance Imaging, Cine; Male; Medical sciences; Middle Aged; Proportional Hazards Models; Prospective Studies; Rest - physiology; Stroke Volume - physiology; United States - epidemiology; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - physiopathology; United States; Heart; Cardiac frequency; Cardiovascular disease; Heart ventricle; Left ventricular failure; Epidemiology; Ethnic group; Vascular disease; Heart rate; Heart disease; Atherosclerosis; Circulatory system; Cardiology; Predictive factor; Left ventricle performance; heart failure; myocardial strain; coronary heart disease; left ventricular dysfunction; cardiac MRI; resting heart rate
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2013.11.027

The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction.
The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population.
Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate.
Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model.
Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487).