• Jiri Jarkovsky, Jindrich Spinar, Benoit Tyl, Françoise Fougerousse, Jiri Vitovec, Ales Linhart, Petr Widimsky, Roman Miklik, Lenka Spinarova, Jan Belohlavek, Filip Malek, Marian Felsoci, Jiri Kettner, Petr Ostadal, Jan Vaclavik, Ladislav Dusek, Petr Lokaj, Alexandre Mebazaa, Alain Cohen Solal, Jiri Parenica, and AHEAD group-authors.
• Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
• Eur. J. Intern. Med. 2020 Aug 1; 78: 88-94.

BackgroundHeart rate (HR) at admission in patients with acute heart failure (AHF) has been shown to be an important risk marker of in-hospital mortality. However, its relation with mid and long-term prognosis as well as the impact of Ejection Fraction (EF) is unknown. Our objective was to study the relationship between long-term survival and HR at admission depending on EF in a cohort of patients hospitalized for AHF.MethodsWe analyzed the data of 2335 patients in sinus rhythm hospitalized for AHF from AHEAD registry. Patients with cardiogenic shock and AHF from surgical or non-cardiac etiology were excluded.ResultsSurvival rates at 6 and 12 months were 84.8% and 78% respectively. Increased age, decreased diastolic BP, lack of PCI during hospitalization, increased creatinine level and increased HR (with different cut-offs according to EF categories) were found as predictors whatever the EF at 6 and 12 months. Optimal prognostic cut-offs of heart rate were identified for Heart Failure with reduced EF at 100 bpm, for Heart Failure with mid-range EF at 90 bpm and for Heart Failure with preserved EF at 80 bpm for both 6 and 12 months.ConclusionOur study suggests that HR at admission appears to be an independent prognostic parameter in AHF patients in sinus rhythm irrespective of EF and can be used to classify patients according to the severity of the disease.Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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