Heart rate: a prognostic factor and therapeutic target in chronic heart failure. The distinct roles of drugs with heart rate-lowering properties

D. Dobre (1, 2) , J. S. Borer (3) , K. Fox (4) , K. Swedberg (5) , K. F. Adams (6) , J. G. Cleland (7) , A. Cohen-Solal (8, 9) , M. Gheorghiade (10) , François Gueyffier (11, 12) , C. M. O'Connor (13) , M. Fiuzat (13) , A. Patak (14) , I. L. Pina (15) , G. Rosano (16) , H. N. Sabbah (17) , L. Tavazzi (18) , F. Zannad (1, 2)

1 Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]
2 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
3 SUNY - State University of New York
4 NHLI - National Heart and Lung Institute
5 GU - Göteborgs Universitet = University of Gothenburg
6 UNC - University of North Carolina [Chapel Hill]
7 University of Hull [United Kingdom]
8 Inserm U942 - Service de Biochimie et de Biologie Moléculaire [AP-HP Hôpital Lariboisière]
9 UPD7 - Université Paris Diderot - Paris 7
10 Northwestern University Feinberg School of Medicine
11 HCL - Hospices Civils de Lyon
12 Evaluation et modélisation des effets thérapeutiques
13 Duke University [Durham]
14 Equipe 8 - Déterminants moléculaires et cliniques de l'architecture cardiaque
15 Albert Einstein College of Medicine [New York]
16 IRCCS San Raffaele Pisana - Istituto di Ricovero e Cura a Carattere Scientifico
17 Henry Ford Hospital
18 Maria Cecilia Hospital

Heart rate not only predicts outcome but may also be a therapeutic target in patients with chronic heart failure. Several classes of pharmacological agents can be used to modulate heart rate, including beta-blockers, ivabradine, digoxin, amiodarone, and verapamil. Choice of agent will depend on heart rhythm, co-morbidities, and disease phenotype. Beneficial and harmful interactions may also exist. The aim of this paper is to summarize the current body of knowledge regarding the relevance of heart rate as a prognostic factor (risk marker) and particularly as a therapeutic target (risk factor) in patients with chronic heart failure, with a special focus on ivabradine, a novel agent that is currently the only available purely bradycardic agent.

Domaines: Sciences du Vivant [q-bio]

D. Dobre, J. S. Borer, K. Fox, K. Swedberg, K. F. Adams, et al.. Heart rate: a prognostic factor and therapeutic target in chronic heart failure. The distinct roles of drugs with heart rate-lowering properties. European Journal of Heart Failure, 2013, 16 (1), pp.76-85. ⟨10.1093/eurjhf/hft129⟩. ⟨hal-02168111⟩