Author + information
- Received August 20, 2013
- Revision received October 15, 2013
- Accepted November 25, 2013
- Published online April 1, 2014.
- Anders Opdahl, MD, PhD∗,†,
- Bharath Ambale Venkatesh, PhD‡,
- Veronica R.S. Fernandes, MD, PhD‡,
- Colin O. Wu, PhD§,
- Khurram Nasir, MD∗,
- Eui-Young Choi, MD, PhD∗,
- Andre L.C. Almeida, MD∗,
- Boaz Rosen, MD∗,
- Benilton Carvalho, PhD‖,
- Thor Edvardsen, MD, PhD†,
- David A. Bluemke, MD, PhD¶,# and
- João A.C. Lima, MD∗,#∗ ()
- ∗Cardiology Division, Johns Hopkins University, Baltimore, Maryland
- †Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Oslo, Norway
- ‡Department of Radiology, Mount Sinai School of Medicine, New York, New York
- §Offices of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- ‖School of Public Health, Johns Hopkins University, Baltimore, Maryland
- ¶National Institute for Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland
- #Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland
- ↵∗Reprint requests and correspondence:
Dr. João A. C. Lima, Division of Cardiology, Johns Hopkins University, 600 North Wolfe Street, Blalock 524D1, Baltimore, Maryland 21287.
Objectives The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction.
Background The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population.
Methods Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate.
Results Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model.
Conclusions Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487)
- cardiac MRI
- coronary heart disease
- heart failure
- left ventricular dysfunction
- myocardial strain
- resting heart rate
Dr. Opdahl received partial grant support from the Raagholt Foundation, the Norwegian Society of Cardiology, the Caroline Musaeus Aarsvold's grant from the Norwegian Medical Association, the Unger Vetlesen Trust, and the Fulbright Foundation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Jeffrey S. Borer, MD, served as Guest Editor for this paper.
- Received August 20, 2013.
- Revision received October 15, 2013.
- Accepted November 25, 2013.
- 2014 American College of Cardiology Foundation