Prognostic value of heart rate at hospital discharge in patients with acute heart failure

The aim of the present study is to establish the association between heart rate (HR) at hospital discharge in patients with acute heart failure (HF), sinus rhythm and reduced left ventricular ejection fraction (LVEF); and outcomes 6 months after. Methods: Eighty-two patients admitted in our institution (July 2010 to June 2015) with acute HF, sinus rhythm and LVEF <50%, were included. Baseline characteristics and outcomes up to 6 months (death by any cause or HF in readmission) were analyzed. The chi-square test was used for discrete variables and Student's t-test for continuous variables. Logistic regression was used for multivariate analysis. Results: Eighty-two patients were assigned in two groups according to HR; Group I: HR <= 70 bpm (30 patients) and Group II: HR >70 bpm (52 patients). 73% were males, mean age 70.49 (+/- 12.4) years old. Cardiovascular risk factors: hypertension (75.6%), diabetes mellitus (48.8%) and dyslipidemia (42.7%). Doppler echo: Group I: LVEF: 35.4% (+/-7.7); Group II 29.7% (+/-11.03), (p=0.015). Treatment at hospital discharge: beta blockers 96.3%, digoxin 7.3%, vasodilators 84.2% and mineralocorticoid receptor antagonists 47.6%. There were no statistical differences in baseline characteristics between both groups. Outcomes up to 6 months (death and readmission) were significantly higher in Group II (32.7% vs 13.3%), p=0.038. The multivariate analysis showed that HR >70 bpm was the only predictor of outcomes at 6 months. (p=0.026). Conclusions: Heart rate <= 70 bpm at hospital discharge in patients with heart failure, sinus rhythm and reduced LVEF, decreased mortality and readmission of HF in these patients..