Resting heart rate in cardiovascular disease
Resting heart rate in cardiovascular disease
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DOI：
10.1016/j.jacc.2007.04.079
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发表时间：
2007-08-28
影响因子：
24
通讯作者：
Tendera, Michal
中科院分区：
文献类型：
--
作者：
Fox, Kim;Borer, Jeffrey S.;Tendera, Michal
静息心率(HR)作为预后因素和潜在治疗靶点的重要性尚未被普遍接受。最近的大型流行病学研究证实了早期的研究，即静息心率是心血管疾病和非心血管疾病男性和女性心血管和全因死亡率的独立预测因素。临床试验数据表明，心率降低本身是急性心肌梗死后、慢性心力衰竭和稳定型心绞痛患者使用β-受体阻滞剂和其他降心率药物的重要机制。病理生理学研究表明，较高的心率对冠状动脉粥样硬化的进展、心肌缺血和室性心律失常的发生以及左心功能有直接的不利影响。研究发现，当心率超过60次/分钟时，风险会持续增加。虽然为特定个体定义最佳心率可能很困难，但似乎希望将静息心率保持在传统定义的90或100次/分钟的心动过速阈值以下。这些发现表明，在未来的心血管指南文件中应考虑HR的潜在作用及其调节。
The importance of resting heart rate (HR) as a prognostic factor and potential therapeutic target is not yet generally accepted. Recent large epidemiologic studies have confirmed earlier studies that showed resting HR to be an independent predictor of cardiovascular and all-cause mortality in men and women with and without diagnosed cardiovascular disease. Clinical trial data suggest that HR reduction itself is an important mechanism of benefit of beta-blockers and other heart-rate lowering drugs used after acute myocardial infarction, in chronic heart failure, and in stable angina pectoris. Pathophysiological studies indicate that a relatively high HR has direct detrimental effects on the progression of coronary atherosclerosis, on the occurrence of myocardial ischemia and ventricular arrhythmias, and on left ventricular function. Studies have found a continuous increase in risk with HR above 60 beats/min. Although it may be difficult to define an optimal HR for a given individual, it seems desirable to maintain resting HR substantially below the traditionally defined tachycardia threshold of 90 or 100 beats/min. These findings suggest that the potential role of HR and its modulation should be considered in future cardiovascular guidance documents.