A low resting heart rate at diagnosis predicts favourable long-term outcome in pulmonary arterial and chronic thromboembolic pulmonary hypertension. A prospective observational study.

Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE

Publication: 2001- : London : BioMed Central Ltd.
Original Publication: London : Current Science Ltd., c2000-

Heart Rate* ; Registries*; Electrocardiography/*statistics & numerical data ; Hypertension, Pulmonary/*diagnosis ; Hypertension, Pulmonary/*epidemiology ; Pulmonary Embolism/*diagnosis ; Pulmonary Embolism/*epidemiology; Comorbidity ; Electrocardiography/methods ; Female ; Humans ; Hypertension, Pulmonary/physiopathology ; Male ; Middle Aged ; Prevalence ; Prognosis ; Prospective Studies ; Pulmonary Embolism/physiopathology ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity ; Switzerland/epidemiology

Background: A low resting heart rate (HR) is prognostically favourable in healthy individuals and in patients with left heart disease. In this study we investigated the impact of HR at diagnosis on long-term outcome in patients with differently classified precapillary pulmonary hypertension (pPH).
Methods: pPH patients diagnosed as pulmonary arterial (PAH) or inoperable chronic thromboembolic pulmonary hypertension (CTEPH) were registered and regularly followed at our centre Baseline characteristics and events defined as either death or lung transplantation were noted. The prognostic value of HR was analysed using Kaplan Meier estimates, live tables and Cox regression.
Results: 206 patients with PAH (148) and inoperable CTEPH (58) were included. The median HR was 82 bpm. pPH with a HR below 82 bpm had a significantly longer overall event-free survival (2409 vs.1332 days, p = .000). This advantage was similarly found if PAH and CTEPH were analysed separately. Although a lower HR was associated with a better hemodynamic and functional class, HR was a strong and independent prognostic marker for transplant free survival even if corrected for age, sex, hemodynamics and functional status.
Conclusion: We show that resting HR at diagnosis is a strong and independent long-term prognostic marker in PAH and CTEPH. Whether reducing HR by pharmacological agents would improve outcome in pPH has to be assessed by future trials with high attention to safety.

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Date Created: 20120905 Date Completed: 20130423 Latest Revision: 20220317

20250114

PMC3490752

10.1186/1465-9921-13-76

22943191