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Symposia & Webinars

Are we doing enough by addressing heart rate to improve survival in HF?

 

The presentation addresses important questions around improving survival in HF patients. Each question is contemplated in different aspects:

  • Is it a good idea to reduce HR?
    • Heart rate reduction by 10 beats saves about 5KG ATP per day; heart rate is closely associated with life expectation
    • Identification of heart rate associated loci and their effects on cardiac conduction and rhythm disorders
  • Do we have the right drug?
    • Mechanism of heart reduction by ivabradine
  • Where to start, where to go?
    • The Rotterdam Study: Resting heart rate and the risk of heart failure in healthy adults
    • The DIAMOND study: Resting heart rate and mortality in heart failure post MI patients
    • Metanalysis: effect of change in heart rate and achieved heart rate on clinical outcomes in HF
    • SHIFT trial: baseline heart rate is a predictor of endpoints on placebo
  • How to do it?
    • Data from SHIFT study and a post-hoc analysis stating that chronic exposure to ivabradine reduces readmissions in the vulnerable phase after hospitalization for worsening systolic heart failure
    • Short-term effects of ivabradine on LV function
    • Short and long term hemodynamic effects of beta blockade differ
    • Clinical problem solving: facilitating beta blocker uptitration
  • What do the guidelines say?
    • SHIFT trial and secondary analysis
    • Ivabradine recommended as the anti-anginal of choice, on top of a beta blocker for heart failure patients with angina

The presentation ends with the following notes:

  • Heart rate is dysregulated by genetic background and neuroendocrine activation
  • It is not a physiological reaction to support cardiac output, target 50-60 bpm.

This video is part of the session “Emerging data in Heart Failure: are we doing enough to improve patients’ survival and quality of life?” held virtually at HFA Discovery 2020, with Professors Martin Cowie, Michael Böhm and Jian Zhang.

View also the other parts of the congress session: