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Erschienen in: Clinical Research in Cardiology 2/2012

01.02.2012 | Original Paper

Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study

verfasst von: Robert S. Hoke, Ursula Müller-Werdan, Christine Lautenschläger, Karl Werdan, Henning Ebelt

Erschienen in: Clinical Research in Cardiology | Ausgabe 2/2012

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Abstract

Purpose

To study the association between baseline heart rate and outcome in patients with multiple organ dysfunction (MODS) as well as the course of heart rate over the first 4 days during MODS.

Methods

Prospective observational study in 89 patients with MODS, defined as an APACHE-II score ≥20. Baseline heart rate (HR0) was determined over a 60-minute period at the time of MODS diagnosis. 28-day all-cause mortality was the primary endpoint of the study, a fall of the APACHE-II score by 4 points or more from day 0 to day 4 constituted the secondary endpoint. Hazard ratios for heart rate of 90 beats per minute (bpm) or greater relative to less than 90 bpm were calculated using Cox proportional hazards model and adjusted for confounding variables.

Results

Median baseline heart rate was 83 bpm in survivors and 92 bpm in non-survivors (p = 0.048). 28-day mortality was 32 and 61% in patients with HR0 < 90 bpm and HR0 ≥ 90 bpm, respectively. The adjusted hazard ratio for 28-day mortality was 2.30 (95% confidence interval 1.21–4.36, p = 0.001) for HR0 ≥ 90 bpm relative to HR0 < 90 bpm. No correlation was found between baseline heart rate and the secondary endpoint. From day 0 to day 4, heart rate remained elevated in all patients, as well as in survivors and non-survivors.

Conclusions

A heart rate ≥90 bpm at the time of MODS diagnosis is an independent risk factor for increased 28-day mortality. As in patients with cardiovascular conditions such as coronary heart disease or chronic heart failure, heart rate might constitute a target for heart rate-lowering therapy in the narrow initial treatment window of MODS.
Literatur
1.
Zurück zum Zitat Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101(6):1644–1655PubMedCrossRef Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101(6):1644–1655PubMedCrossRef
2.
Zurück zum Zitat Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med 26(11):1793–1800PubMedCrossRef Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med 26(11):1793–1800PubMedCrossRef
3.
Zurück zum Zitat Moerer O, Schmid A, Hofmann M, Herklotz A, Reinhart K, Werdan K, Schneider H, Burchardi H (2002) Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use. Intensive Care Med 28(10):1440–1446PubMedCrossRef Moerer O, Schmid A, Hofmann M, Herklotz A, Reinhart K, Werdan K, Schneider H, Burchardi H (2002) Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use. Intensive Care Med 28(10):1440–1446PubMedCrossRef
4.
Zurück zum Zitat Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216(2):117–134PubMedCrossRef Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216(2):117–134PubMedCrossRef
5.
6.
Zurück zum Zitat Fox K, Borer JS, Camm AJ, Danchin N, Ferrari R, Lopez Sendon JL, Steg PG, Tardif JC, Tavazzi L, Tendera M (2007) Resting heart rate in cardiovascular disease. J Am Coll Cardiol 50(9):823–830PubMedCrossRef Fox K, Borer JS, Camm AJ, Danchin N, Ferrari R, Lopez Sendon JL, Steg PG, Tardif JC, Tavazzi L, Tendera M (2007) Resting heart rate in cardiovascular disease. J Am Coll Cardiol 50(9):823–830PubMedCrossRef
7.
Zurück zum Zitat Azimi G, Vincent JL (1986) Ultimate survival from septic shock. Resuscitation 14(4):245–253PubMedCrossRef Azimi G, Vincent JL (1986) Ultimate survival from septic shock. Resuscitation 14(4):245–253PubMedCrossRef
8.
Zurück zum Zitat Schmidt H, Muller-Werdan U, Hoffmann T, Francis DP, Piepoli MF, Rauchhaus M, Prondzinsky R, Loppnow H, Buerke M, Hoyer D, Werdan K (2005) Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups. Crit Care Med 33(9):1994–2002PubMedCrossRef Schmidt H, Muller-Werdan U, Hoffmann T, Francis DP, Piepoli MF, Rauchhaus M, Prondzinsky R, Loppnow H, Buerke M, Hoyer D, Werdan K (2005) Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups. Crit Care Med 33(9):1994–2002PubMedCrossRef
9.
Zurück zum Zitat Hennen R, Friedrich I, Hoyer D, Nuding S, Rauchhaus M, Schulze M, Schlisske S, Schwesig R, Schlitt A, Buerke M, Muller-Werdan U, Werdan K, Schmidt H (2008) Autonomic dysfunction and beta-adrenergic blockers in multiple organ dysfunction syndrome. Dtsch Med Wochenschr 133(48):2500–2504PubMedCrossRef Hennen R, Friedrich I, Hoyer D, Nuding S, Rauchhaus M, Schulze M, Schlisske S, Schwesig R, Schlitt A, Buerke M, Muller-Werdan U, Werdan K, Schmidt H (2008) Autonomic dysfunction and beta-adrenergic blockers in multiple organ dysfunction syndrome. Dtsch Med Wochenschr 133(48):2500–2504PubMedCrossRef
10.
Zurück zum Zitat Suzuki T, Morisaki H, Serita R, Yamamoto M, Kotake Y, Ishizaka A, Takeda J (2005) Infusion of the beta-adrenergic blocker esmolol attenuates myocardial dysfunction in septic rats. Crit Care Med 33(10):2294–2301PubMedCrossRef Suzuki T, Morisaki H, Serita R, Yamamoto M, Kotake Y, Ishizaka A, Takeda J (2005) Infusion of the beta-adrenergic blocker esmolol attenuates myocardial dysfunction in septic rats. Crit Care Med 33(10):2294–2301PubMedCrossRef
11.
Zurück zum Zitat Ackland GL, Yao ST, Rudiger A, Dyson A, Stidwill R, Poputnikov D, Singer M, Gourine AV (2010) Cardioprotection, attenuated systemic inflammation, and survival benefit of beta1-adrenoceptor blockade in severe sepsis in rats. Crit Care Med 38(2):388–394PubMedCrossRef Ackland GL, Yao ST, Rudiger A, Dyson A, Stidwill R, Poputnikov D, Singer M, Gourine AV (2010) Cardioprotection, attenuated systemic inflammation, and survival benefit of beta1-adrenoceptor blockade in severe sepsis in rats. Crit Care Med 38(2):388–394PubMedCrossRef
12.
Zurück zum Zitat Werdan K, Pilz G, Bujdoso O, Fraunberger P, Neeser G, Schmieder RE, Viell B, Marget W, Seewald M, Walger P, Stuttmann R, Speichermann N, Peckelsen C, Kurowski V, Osterhues HH, Verner L, Neumann R, Muller-Werdan U (2007) Score-based immunoglobulin G therapy of patients with sepsis: the SBITS study. Crit Care Med 35(12):2693–2701PubMedCrossRef Werdan K, Pilz G, Bujdoso O, Fraunberger P, Neeser G, Schmieder RE, Viell B, Marget W, Seewald M, Walger P, Stuttmann R, Speichermann N, Peckelsen C, Kurowski V, Osterhues HH, Verner L, Neumann R, Muller-Werdan U (2007) Score-based immunoglobulin G therapy of patients with sepsis: the SBITS study. Crit Care Med 35(12):2693–2701PubMedCrossRef
13.
Zurück zum Zitat Schmidt H, Hennen R, Keller A, Russ M, Muller-Werdan U, Werdan K, Buerke M (2006) Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome. Intensive Care Med 32(8):1248–1251PubMedCrossRef Schmidt H, Hennen R, Keller A, Russ M, Muller-Werdan U, Werdan K, Buerke M (2006) Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome. Intensive Care Med 32(8):1248–1251PubMedCrossRef
14.
Zurück zum Zitat Schmidt H, Hoyer D, Hennen R, Heinroth K, Rauchhaus M, Prondzinsky R, Hottenrott K, Buerke M, Muller-Werdan U, Werdan K (2008) Autonomic dysfunction predicts both 1- and 2-month mortality in middle-aged patients with multiple organ dysfunction syndrome. Crit Care Med 36(3):967–970PubMedCrossRef Schmidt H, Hoyer D, Hennen R, Heinroth K, Rauchhaus M, Prondzinsky R, Hottenrott K, Buerke M, Muller-Werdan U, Werdan K (2008) Autonomic dysfunction predicts both 1- and 2-month mortality in middle-aged patients with multiple organ dysfunction syndrome. Crit Care Med 36(3):967–970PubMedCrossRef
15.
Zurück zum Zitat Unnebrink K, Windeler J (2001) Intention-to-treat: methods for dealing with missing values in clinical trials of progressively deteriorating diseases. Stat Med 20(24):3931–3946PubMedCrossRef Unnebrink K, Windeler J (2001) Intention-to-treat: methods for dealing with missing values in clinical trials of progressively deteriorating diseases. Stat Med 20(24):3931–3946PubMedCrossRef
16.
Zurück zum Zitat McAlister FA, Wiebe N, Ezekowitz JA, Leung AA, Armstrong PW (2009) Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med 150(11):784–794PubMed McAlister FA, Wiebe N, Ezekowitz JA, Leung AA, Armstrong PW (2009) Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med 150(11):784–794PubMed
17.
Zurück zum Zitat Cucherat M (2007) Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials. Eur Heart J 28(24):3012–3019PubMedCrossRef Cucherat M (2007) Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials. Eur Heart J 28(24):3012–3019PubMedCrossRef
18.
Zurück zum Zitat Fox K, Ford I, Steg PG, Tendera M, Ferrari R (2008) Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 372(9641):807–816PubMedCrossRef Fox K, Ford I, Steg PG, Tendera M, Ferrari R (2008) Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 372(9641):807–816PubMedCrossRef
19.
Zurück zum Zitat Swedberg K, Komajda M, Bohm M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L (2010) Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. doi:10.1016/S0140-6736(10)61198-1 Swedberg K, Komajda M, Bohm M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L (2010) Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. doi:10.​1016/​S0140-6736(10)61198-1
20.
Zurück zum Zitat Kumar A, Krieger A, Symeoneides S, Parrillo JE (2001) Myocardial dysfunction in septic shock: part II. Role of cytokines and nitric oxide. J Cardiothorac Vasc Anesth 15(4):485–511PubMedCrossRef Kumar A, Krieger A, Symeoneides S, Parrillo JE (2001) Myocardial dysfunction in septic shock: part II. Role of cytokines and nitric oxide. J Cardiothorac Vasc Anesth 15(4):485–511PubMedCrossRef
21.
Zurück zum Zitat Boldt J, Menges T, Kuhn D, Diridis C, Hempelmann G (1995) Alterations in circulating vasoactive substances in the critically ill—a comparison between survivors and non-survivors. Intensive Care Med 21(3):218–225PubMedCrossRef Boldt J, Menges T, Kuhn D, Diridis C, Hempelmann G (1995) Alterations in circulating vasoactive substances in the critically ill—a comparison between survivors and non-survivors. Intensive Care Med 21(3):218–225PubMedCrossRef
22.
Zurück zum Zitat Benedict CR, Grahame-Smith DG (1978) Plasma noradrenaline and adrenaline concentrations and dopamine-beta-hydroxylase activity in patients with shock due to septicaemia, trauma and haemorrhage. Q J Med 47(185):1–20PubMed Benedict CR, Grahame-Smith DG (1978) Plasma noradrenaline and adrenaline concentrations and dopamine-beta-hydroxylase activity in patients with shock due to septicaemia, trauma and haemorrhage. Q J Med 47(185):1–20PubMed
23.
Zurück zum Zitat Stein PK (2008) Measures of parasympathetic function and risk stratification in critical care. Crit Care Med 36(3):1025–1027PubMedCrossRef Stein PK (2008) Measures of parasympathetic function and risk stratification in critical care. Crit Care Med 36(3):1025–1027PubMedCrossRef
24.
Zurück zum Zitat Muller-Werdan U, Schumann H, Loppnow H, Fuchs R, Darmer D, Stadler J, Holtz J, Werdan K (1998) Endotoxin and tumor necrosis factor alpha exert a similar proinflammatory effect in neonatal rat cardiomyocytes, but have different cardiodepressant profiles. J Mol Cell Cardiol 30(5):1027–1036PubMedCrossRef Muller-Werdan U, Schumann H, Loppnow H, Fuchs R, Darmer D, Stadler J, Holtz J, Werdan K (1998) Endotoxin and tumor necrosis factor alpha exert a similar proinflammatory effect in neonatal rat cardiomyocytes, but have different cardiodepressant profiles. J Mol Cell Cardiol 30(5):1027–1036PubMedCrossRef
25.
Zurück zum Zitat Zorn-Pauly K, Pelzmann B, Lang P, Machler H, Schmidt H, Ebelt H, Werdan K, Koidl B, Muller-Werdan U (2007) Endotoxin impairs the human pacemaker current If. Shock 28(6):655–661PubMed Zorn-Pauly K, Pelzmann B, Lang P, Machler H, Schmidt H, Ebelt H, Werdan K, Koidl B, Muller-Werdan U (2007) Endotoxin impairs the human pacemaker current If. Shock 28(6):655–661PubMed
26.
Zurück zum Zitat Takayama K, Yuhki K, Ono K, Fujino T, Hara A, Yamada T, Kuriyama S, Karibe H, Okada Y, Takahata O, Taniguchi T, Iijima T, Iwasaki H, Narumiya S, Ushikubi F (2005) Thromboxane A2 and prostaglandin F2alpha mediate inflammatory tachycardia. Nat Med 11(5):562–566PubMedCrossRef Takayama K, Yuhki K, Ono K, Fujino T, Hara A, Yamada T, Kuriyama S, Karibe H, Okada Y, Takahata O, Taniguchi T, Iijima T, Iwasaki H, Narumiya S, Ushikubi F (2005) Thromboxane A2 and prostaglandin F2alpha mediate inflammatory tachycardia. Nat Med 11(5):562–566PubMedCrossRef
27.
Zurück zum Zitat Werdan K, Schmidt H, Ebelt H, Zorn-Pauly K, Koidl B, Hoke RS, Heinroth K, Muller-Werdan U (2009) Impaired regulation of cardiac function in sepsis, SIRS, and MODS. Can J Physiol Pharmacol 87(4):266–274PubMedCrossRef Werdan K, Schmidt H, Ebelt H, Zorn-Pauly K, Koidl B, Hoke RS, Heinroth K, Muller-Werdan U (2009) Impaired regulation of cardiac function in sepsis, SIRS, and MODS. Can J Physiol Pharmacol 87(4):266–274PubMedCrossRef
28.
Zurück zum Zitat Joulin O, Marechaux S, Hassoun S, Montaigne D, Lancel S, Neviere R (2009) Cardiac force-frequency relationship and frequency-dependent acceleration of relaxation are impaired in LPS-treated rats. Crit Care 13(1):R14PubMedCrossRef Joulin O, Marechaux S, Hassoun S, Montaigne D, Lancel S, Neviere R (2009) Cardiac force-frequency relationship and frequency-dependent acceleration of relaxation are impaired in LPS-treated rats. Crit Care 13(1):R14PubMedCrossRef
29.
Zurück zum Zitat Sasse SA, Chen PA, Mahutte CK (1996) Relationship of changes in cardiac output to changes in heart rate in medical ICU patients. Intensive Care Med 22(5):409–414PubMedCrossRef Sasse SA, Chen PA, Mahutte CK (1996) Relationship of changes in cardiac output to changes in heart rate in medical ICU patients. Intensive Care Med 22(5):409–414PubMedCrossRef
30.
Zurück zum Zitat Muller-Werdan U, Buerke M, Ebelt H, Heinroth KM, Herklotz A, Loppnow H, Russ M, Schlegel F, Schlitt A, Schmidt HB, Soffker G, Werdan K (2006) Septic cardiomyopathy—a not yet discovered cardiomyopathy? Exp Clin Cardiol 11(3):226–236PubMed Muller-Werdan U, Buerke M, Ebelt H, Heinroth KM, Herklotz A, Loppnow H, Russ M, Schlegel F, Schlitt A, Schmidt HB, Soffker G, Werdan K (2006) Septic cardiomyopathy—a not yet discovered cardiomyopathy? Exp Clin Cardiol 11(3):226–236PubMed
31.
Zurück zum Zitat Link A, Reil JC, Selejan S, Bohm M (2009) Effect of ivabradine in dobutamine induced sinus tachycardia in a case of acute heart failure. Clin Res Cardiol 98(8):513–515PubMedCrossRef Link A, Reil JC, Selejan S, Bohm M (2009) Effect of ivabradine in dobutamine induced sinus tachycardia in a case of acute heart failure. Clin Res Cardiol 98(8):513–515PubMedCrossRef
32.
Zurück zum Zitat De Ferrari GM, Mazzuero A, Agnesina L, Bertoletti A, Lettino M, Campana C, Schwartz PJ, Tavazzi L (2008) Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. Eur J Heart Fail 10(6):550–555PubMedCrossRef De Ferrari GM, Mazzuero A, Agnesina L, Bertoletti A, Lettino M, Campana C, Schwartz PJ, Tavazzi L (2008) Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. Eur J Heart Fail 10(6):550–555PubMedCrossRef
33.
Zurück zum Zitat Vitale D, De Santis V, Guarracino F, Fontana A, Pellegrini F, Tritapepe L (2010) Use of ivabradine in catecholamine-induced tachycardia after high-risk cardiac surgery. Clin Res Cardiol 99(12):853–855PubMedCrossRef Vitale D, De Santis V, Guarracino F, Fontana A, Pellegrini F, Tritapepe L (2010) Use of ivabradine in catecholamine-induced tachycardia after high-risk cardiac surgery. Clin Res Cardiol 99(12):853–855PubMedCrossRef
34.
Zurück zum Zitat Reil JC, Custodis F, Swedberg K, Komajda M, Borer JS, Ford I, Tavazzi L, Laufs U, Bohm M (2011) Heart rate reduction in cardiovascular disease and therapy. Clin Res Cardiol 100(1):11–19PubMedCrossRef Reil JC, Custodis F, Swedberg K, Komajda M, Borer JS, Ford I, Tavazzi L, Laufs U, Bohm M (2011) Heart rate reduction in cardiovascular disease and therapy. Clin Res Cardiol 100(1):11–19PubMedCrossRef
35.
Zurück zum Zitat Colin P, Ghaleh B, Monnet X, Hittinger L, Berdeaux A (2004) Effect of graded heart rate reduction with ivabradine on myocardial oxygen consumption and diastolic time in exercising dogs. J Pharmacol Exp Ther 308(1):236–240PubMedCrossRef Colin P, Ghaleh B, Monnet X, Hittinger L, Berdeaux A (2004) Effect of graded heart rate reduction with ivabradine on myocardial oxygen consumption and diastolic time in exercising dogs. J Pharmacol Exp Ther 308(1):236–240PubMedCrossRef
36.
Zurück zum Zitat Reil JC, Reil GH, Bohm M (2009) Heart rate reduction by I(f)-channel inhibition and its potential role in heart failure with reduced and preserved ejection fraction. Trends Cardiovasc Med 19(5):152–157PubMedCrossRef Reil JC, Reil GH, Bohm M (2009) Heart rate reduction by I(f)-channel inhibition and its potential role in heart failure with reduced and preserved ejection fraction. Trends Cardiovasc Med 19(5):152–157PubMedCrossRef
37.
Zurück zum Zitat Mulder P, Barbier S, Chagraoui A, Richard V, Henry JP, Lallemand F, Renet S, Lerebours G, Mahlberg-Gaudin F, Thuillez C (2004) Long-term heart rate reduction induced by the selective I(f) current inhibitor ivabradine improves left ventricular function and intrinsic myocardial structure in congestive heart failure. Circulation 109(13):1674–1679PubMedCrossRef Mulder P, Barbier S, Chagraoui A, Richard V, Henry JP, Lallemand F, Renet S, Lerebours G, Mahlberg-Gaudin F, Thuillez C (2004) Long-term heart rate reduction induced by the selective I(f) current inhibitor ivabradine improves left ventricular function and intrinsic myocardial structure in congestive heart failure. Circulation 109(13):1674–1679PubMedCrossRef
38.
Zurück zum Zitat Koester R, Kaehler J, Meinertz T (2011) Ivabradine for the treatment of stable angina pectoris in octogenarians. Clin Res Cardiol 100(2):121–128PubMedCrossRef Koester R, Kaehler J, Meinertz T (2011) Ivabradine for the treatment of stable angina pectoris in octogenarians. Clin Res Cardiol 100(2):121–128PubMedCrossRef
39.
Zurück zum Zitat Koester R, Kaehler J, Ebelt H, Soeffker G, Werdan K, Meinertz T (2010) Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice. Clin Res Cardiol 99(10):665–672PubMedCrossRef Koester R, Kaehler J, Ebelt H, Soeffker G, Werdan K, Meinertz T (2010) Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice. Clin Res Cardiol 99(10):665–672PubMedCrossRef
40.
Zurück zum Zitat Sander O, Welters ID, Foex P, Sear JW (2005) Impact of prolonged elevated heart rate on incidence of major cardiac events in critically ill patients with a high risk of cardiac complications. Crit Care Med 33(1):81–88 (discussion 241–242)PubMedCrossRef Sander O, Welters ID, Foex P, Sear JW (2005) Impact of prolonged elevated heart rate on incidence of major cardiac events in critically ill patients with a high risk of cardiac complications. Crit Care Med 33(1):81–88 (discussion 241–242)PubMedCrossRef
41.
Zurück zum Zitat Dunser MW, Hasibeder WR (2009) Sympathetic overstimulation during critical illness: adverse effects of adrenergic stress. J Intensive Care Med 24(5):293–316PubMedCrossRef Dunser MW, Hasibeder WR (2009) Sympathetic overstimulation during critical illness: adverse effects of adrenergic stress. J Intensive Care Med 24(5):293–316PubMedCrossRef
42.
Zurück zum Zitat Parker MM, Shelhamer JH, Natanson C, Alling DW, Parrillo JE (1987) Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. Crit Care Med 15(10):923–929PubMedCrossRef Parker MM, Shelhamer JH, Natanson C, Alling DW, Parrillo JE (1987) Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. Crit Care Med 15(10):923–929PubMedCrossRef
43.
Zurück zum Zitat Hjalmarson A, Gilpin EA, Kjekshus J, Schieman G, Nicod P, Henning H, Ross J Jr (1990) Influence of heart rate on mortality after acute myocardial infarction. Am J Cardiol 65(9):547–553PubMedCrossRef Hjalmarson A, Gilpin EA, Kjekshus J, Schieman G, Nicod P, Henning H, Ross J Jr (1990) Influence of heart rate on mortality after acute myocardial infarction. Am J Cardiol 65(9):547–553PubMedCrossRef
44.
Zurück zum Zitat Disegni E, Goldbourt U, Reicher-Reiss H, Kaplinsky E, Zion M, Boyko V, Behar S (1995) The predictive value of admission heart rate on mortality in patients with acute myocardial infarction. SPRINT Study Group. Secondary Prevention Reinfarction Israeli Nifedipine Trial. J Clin Epidemiol 48(10):1197–1205PubMedCrossRef Disegni E, Goldbourt U, Reicher-Reiss H, Kaplinsky E, Zion M, Boyko V, Behar S (1995) The predictive value of admission heart rate on mortality in patients with acute myocardial infarction. SPRINT Study Group. Secondary Prevention Reinfarction Israeli Nifedipine Trial. J Clin Epidemiol 48(10):1197–1205PubMedCrossRef
45.
Zurück zum Zitat Zuanetti G, Mantini L, Hernandez-Bernal F, Barlera S, di Gregorio D, Latini R, Maggioni AP (1998) Relevance of heart rate as a prognostic factor in patients with acute myocardial infarction: insights from the GISSI-2 study. Eur Heart J 19(Suppl F):F19–F26PubMed Zuanetti G, Mantini L, Hernandez-Bernal F, Barlera S, di Gregorio D, Latini R, Maggioni AP (1998) Relevance of heart rate as a prognostic factor in patients with acute myocardial infarction: insights from the GISSI-2 study. Eur Heart J 19(Suppl F):F19–F26PubMed
46.
Zurück zum Zitat Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R (2008) Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 372(9641):817–821PubMedCrossRef Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R (2008) Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 372(9641):817–821PubMedCrossRef
47.
Zurück zum Zitat Bohm M, Swedberg K, Komajda M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L (2010) Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trial. Lancet 376(9744):886–894PubMedCrossRef Bohm M, Swedberg K, Komajda M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L (2010) Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trial. Lancet 376(9744):886–894PubMedCrossRef
48.
Zurück zum Zitat Schmittinger CA, Wurzinger B, Deutinger M, Wohlmuth C, Knotzer H, Torgersen C, Dunser MW, Hasibeder WR (2010) How to protect the heart in septic shock: a hypothesis on the pathophysiology and treatment of septic heart failure. Med Hypotheses 74(3):460–465PubMedCrossRef Schmittinger CA, Wurzinger B, Deutinger M, Wohlmuth C, Knotzer H, Torgersen C, Dunser MW, Hasibeder WR (2010) How to protect the heart in septic shock: a hypothesis on the pathophysiology and treatment of septic heart failure. Med Hypotheses 74(3):460–465PubMedCrossRef
49.
Zurück zum Zitat Huston JM, Tracey KJ (2011) The pulse of inflammation: heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy. J Intern Med 269(1):45–53PubMedCrossRef Huston JM, Tracey KJ (2011) The pulse of inflammation: heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy. J Intern Med 269(1):45–53PubMedCrossRef
50.
Zurück zum Zitat Nuding S, Ebelt H, Hoke RS, Krummenerl A, Wienke A, Muller-Werdan U, Werdan K (2011) Reducing elevated heart rate in patients with multiple organ dysfunction syndrome by the I (f) (funny channel current) inhibitor ivabradine: MODI (f)Y Trial. Clin Res Cardiol 100(10):915–923PubMedCrossRef Nuding S, Ebelt H, Hoke RS, Krummenerl A, Wienke A, Muller-Werdan U, Werdan K (2011) Reducing elevated heart rate in patients with multiple organ dysfunction syndrome by the I (f) (funny channel current) inhibitor ivabradine: MODI (f)Y Trial. Clin Res Cardiol 100(10):915–923PubMedCrossRef
51.
Zurück zum Zitat Pilz G, Werdan K (1990) Cardiovascular parameters and scoring systems in the evaluation of response to therapy in sepsis and septic shock. Infection 18(5):253–262PubMedCrossRef Pilz G, Werdan K (1990) Cardiovascular parameters and scoring systems in the evaluation of response to therapy in sepsis and septic shock. Infection 18(5):253–262PubMedCrossRef
52.
Zurück zum Zitat Prondzinsky R, Lemm H, Swyter M, Wegener N, Unverzagt S, Carter JM, Russ M, Schlitt A, Buerke U, Christoph A, Schmidt H, Winkler M, Thiery J, Werdan K, Buerke M (2010) Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK Trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med 38(1):152–160PubMedCrossRef Prondzinsky R, Lemm H, Swyter M, Wegener N, Unverzagt S, Carter JM, Russ M, Schlitt A, Buerke U, Christoph A, Schmidt H, Winkler M, Thiery J, Werdan K, Buerke M (2010) Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK Trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med 38(1):152–160PubMedCrossRef
53.
Zurück zum Zitat Kumar A, Schupp E, Bunnell E, Ali A, Milcarek B, Parrillo JE (2008) Cardiovascular response to dobutamine stress predicts outcome in severe sepsis and septic shock. Crit Care 12(2):R35PubMedCrossRef Kumar A, Schupp E, Bunnell E, Ali A, Milcarek B, Parrillo JE (2008) Cardiovascular response to dobutamine stress predicts outcome in severe sepsis and septic shock. Crit Care 12(2):R35PubMedCrossRef
54.
Zurück zum Zitat Leibovici L, Gafter-Gvili A, Paul M, Almanasreh N, Tacconelli E, Andreassen S, Nielsen AD, Frank U, Cauda R (2007) Relative tachycardia in patients with sepsis: an independent risk factor for mortality. QJM 100(10):629–634PubMedCrossRef Leibovici L, Gafter-Gvili A, Paul M, Almanasreh N, Tacconelli E, Andreassen S, Nielsen AD, Frank U, Cauda R (2007) Relative tachycardia in patients with sepsis: an independent risk factor for mortality. QJM 100(10):629–634PubMedCrossRef
55.
Zurück zum Zitat Jardin F, Fourme T, Page B, Loubieres Y, Vieillard-Baron A, Beauchet A, Bourdarias JP (1999) Persistent preload defect in severe sepsis despite fluid loading: a longitudinal echocardiographic study in patients with septic shock. Chest 116(5):1354–1359PubMedCrossRef Jardin F, Fourme T, Page B, Loubieres Y, Vieillard-Baron A, Beauchet A, Bourdarias JP (1999) Persistent preload defect in severe sepsis despite fluid loading: a longitudinal echocardiographic study in patients with septic shock. Chest 116(5):1354–1359PubMedCrossRef
56.
Zurück zum Zitat Flieger RR (2004) Pathophysiologie-orientiertes, prognose-validiertes und praktikables Monitoring von Patienten mit schwerer Sepsis und septischem Schock. Univ. Diss. Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale Flieger RR (2004) Pathophysiologie-orientiertes, prognose-validiertes und praktikables Monitoring von Patienten mit schwerer Sepsis und septischem Schock. Univ. Diss. Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
Metadaten
Titel
Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study
verfasst von
Robert S. Hoke
Ursula Müller-Werdan
Christine Lautenschläger
Karl Werdan
Henning Ebelt
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Research in Cardiology / Ausgabe 2/2012
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-011-0375-3

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