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Heart Failure Reviews

Erschienen in:

23.04.2018

The effects of heart rate control in chronic heart failure with reduced ejection fraction

verfasst von: Dario Grande, Massimo Iacoviello, Nadia Aspromonte

Erschienen in: Heart Failure Reviews | Ausgabe 4/2018

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Abstract

Elevated heart rate has been associated with worse prognosis both in the general population and in patients with heart failure. Heart rate is finely modulated by neurohormonal signals and it reflects the balance between the sympathetic and the parasympathetic limbs of the autonomic nervous system. For this reason, elevated heart rate in heart failure has been considered an epiphenomenon of the sympathetic hyperactivation during heart failure. However, experimental and clinical evidence suggests that high heart rate could have a direct pathogenetic role. Consequently, heart rate might act as a pathophysiological mediator of heart failure as well as a marker of adverse outcome. This hypothesis has been supported by the observation that the positive effect of beta-blockade could be linked to the degree of heart rate reduction. In addition, the selective heart rate control with ivabradine has recently been demonstrated to be beneficial in patients with heart failure and left ventricular systolic dysfunction. The objective of this review is to examine the pathophysiological implications of elevated heart rate in chronic heart failure and explore the mechanisms underlying the effects of pharmacological heart rate control.

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Titel: The effects of heart rate control in chronic heart failure with reduced ejection fraction
verfasst von: Dario Grande
Massimo Iacoviello
Nadia Aspromonte
Publikationsdatum: 23.04.2018
Verlag: Springer US
Erschienen in: Heart Failure Reviews / Ausgabe 4/2018
Print ISSN: 1382-4147
Elektronische ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-018-9704-1

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