Abstract
It has long been known that life span is inversely related to resting heart rate in most organisms. This association between heart rate and survival has been attributed to the metabolic rate, which is greater in smaller animals and is directly associated with heart rate. Studies have shown that heart rate is related to survival in apparently healthy individuals and in patients with different underlying cardiovascular diseases. A decrease in heart rate due to therapeutic interventions may result in an increase in survival. However, there are many factors regulating heart rate, and it is quite plausible that these may independently affect life expectancy. Nonetheless, a fast heart rate itself affects the cardiovascular system in multiple ways (it increases ventricular work, myocardial oxygen consumption, endothelial stress, aortic/arterial stiffness, decreases myocardial oxygen supply, other) which, in turn, may affect survival. In this brief review, the effects of heart rate on the heart, arterial system and survival will be discussed.
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References
1.
Levine HJ: Rest heart rate and life expectancy. J Am Coll Cardiol 1997;30:1104-1106.
[PubMed]
2.
Hulbert AJ, Ramplona R, Buffenstein R, Buttemer WA: Life and death: Metabolic rate, membrane composition, and life span of animals. Physiol Rev 2007;87:1175-1213.
[PubMed]
3.
DiFrancesco D, Borer JS: The funny current: cellular basis for the control of heart rate. Drugs 2007;67:15-24.
[PubMed]
4.
Olshansky B, Sullivan RM: Inappropriate sinus tachycardia. J Am Coll Cardiol 2013;61:793-801.
[PubMed]
5.
Eigelsheim M, Newton-Cheh C, Sotoodehnia, et al: Genome-wide association analysis identifies multiple loci related to resting heart rate. Hum Mol Genet 2010;19:3385-3394.
[PubMed]
6.
Vaanholt LM, Daan S, Schubert KA, Visser GH: Metabolism and aging: effects of cold exposure on metabolic rate, body composition, and longevity in mice. Physiol Biochem Zool 2009;82:314-324.
[PubMed]
7.
Boudoulas H, Rittgers SE, Lewis RP, Leier CV, Weissler AM: Changes in diastolic time with various pharmacologic agents: implication for myocardial perfusion. Circulation 1979;60:164-169.
[PubMed]
8.
Obdahl A, Venkatesh BA, Fernandes VRS, Wu CO, Nasir K, Choi EY, Almeida AL, Rosen B, Carvalho B, Edvardsen T, Bluemke DA, Lima JAC: Resting heart rate as predictor for left ventricular dysfunction and heart failure. MESA (Multiethnic Study of Atherosclerosis). J Am Coll Cardiol 2014;63:1182-1189.
[PubMed]
9.
Levy R, White PD, Stroud WD, Cha BG: Transient tachycardia. Prognostic significance alone and in association with transient hypertension. JAMA 1945;129:585-588.
10.
Boudoulas H, Leier CV: Clinical perspective: myocardial perfusion pressure in the age of afterload reduction. ACC Curr J Rev 2000;9:27-29.
11.
Boudoulas H, Karayannacos PE, Kien N, Lewis RP, Kakos GS, Leir CV, Vasco JS: Noninvasive method of estimating relative subendocardial flow employing diastolic time; in Dietrich E (ed): Noninvasive Assessment of the Cardiovascular System. Littleton, John Wright-PSG Inc, 1982, pp 211-217.
12.
Boudoulas H: Diastolic time: the forgotten dynamic factor. Implications for myocardial perfusion. Acta Cardiol 1991;46:61-71.
[PubMed]
13.
Boudoulas H: Diastolic time: implications for myocardial perfusion and ventricular filling. Hell J Cardiol 1991;32:400-409.
14.
Boudoulas H, Dervenagas S, Fulkerson PK, Bush CA, Lewis RP: Effect of heart rate on diastolic time and left ventricular performance in patients with atrial fibrillation; in: Noninvasive Cardiovascular Diagnosis, ed 2. Littleton, Mass PSG Inc, 1981, pp 433-445.
15.
Ling L, Khammy O, Byne M, Amirahmadi F, Foster A, Li G, Zhang L, Remedios C, Chen C, Kaye DM: Irregular rhythm adversely influences calcium handling in ventricular myocardium. Circ Heart Fail 2012;5:786-793.
[PubMed]
16.
Boudoulas KD, Vlachopoulos C, Raman SV, Sparkas EA, Triposkiadis F, Stefanadis C, Boudoulas H: Aortic function: from the research laboratory to the clinic. Cardiology 2012;121:31-42.
[PubMed]
17.
Boudoulas H, Stefanadis C: The Aorta: Structure, Function, Dysfunction, and Diseases. New York, Informa Healthcare, 2009.
18.
Boudoulas H, Toutouzas P, Wooley CF: Functional Abnormalities of the Aorta. Futura, Armonk, 1996.
19.
Nichols WW, O'Rourke MF, Vlachopoulos C (eds): McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles, ed 6. London, Hoder Arnold, 2011.
20.
Thorin E, Thorin-Trescases N: Vascular endothelial aging, heartbeat after heartbeat. Cardiovasc Res 2009;84:24-32.
[PubMed]
21.
Custodis F, Schirmer SH, Baumhakel M, Heusch G, Böhm M, Laufs U: Vascular pathophysiology in response to increased heart rate. J Am Coll Cardiol 2010;56:1973-1983.
[PubMed]
22.
Giannattasio C, Vincenti A, Failla M, Capta A, Ciro A, De Ceglia S, Getile G, Brambilla R, Mancia G: Effects of heart rate changes on arterial distensibility in humans. Hypertension 2003;42:253-256.
[PubMed]
23.
Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby D, Webb DJ: The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000;525:263-270.
[PubMed]
24.
Tartiere-Kesri L, Tartieri JM, Logeart D, Bwauvais F, Solal C: Increased proximal arterial stiffness and cardiac response with moderate exercise in patients with heart failure and preserved ejection fraction. J Am Coll Cardiol 2012;59:455-461.
[PubMed]
25.
Borlaud BA: Heart rate reduction. It is not just for ventricles anymore. J Am Coll Cardiol 2013;62:1986-1987.
[PubMed]
26.
Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thuster A, O'Rourke M: Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes. Principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006;113:1213-1225.
[PubMed]
27.
Benetos A, Adamopoulos C, Bureau JM, Temmar M, Labat C, Bean K, Thomas F, Pannier B, Asmar R, Zureik M, Safar M, Guize L: Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period. Circulation 2002;105:1202-1207.
[PubMed]
28.
Böhm M, Reil JC, Danchin N, Thoenes M, Bramlage P, Volpe M. Association of heart rate with microalbuminuria in cardiovascular risk patients: data from I-SEARCH. J Hypertens 2008;26:18-25.
[PubMed]
29.
Palatini P, Casiglia E, Pauletto P, Staessen J, Kaciroti N, Jukius S: Relationship of tachycardia with high blood pressure and metabolic abnormalities. Hypertension 1997;30:1267-1273.
[PubMed]
30.
O' Hartaigh B, Bosch JA, Carroll D, Hemming K, Pilz S, Loebroks A, Kleber ME, Grammer TB, Fisher JE, Boehm B, Marz W, Thomas NG: Evidence of a synergistic association between heart rate, inflammation, and cardiovascular mortality in patients undergoing coronary angiography. Eur Heart J 2013;34:932-941.
[PubMed]
31.
Zulfigar U, Jurivich DA, Singer DH: Relation of high heart rate variability to healthy longevity. Am J Cardiol 2010;105:1181-1185.
[PubMed]
32.
Grassi G, Vailati S, Bertinieri G, Seravalle G, Stella ML, Dell'Oro R, Mancia G: Heart rate as marker of sympathetic activity. J Hypertens 1998;16:1635-1639.
[PubMed]
33.
Rogowski O, Shapira I, Shirom A, Melamed S, Toker S, Berliner S: Heart rate and microinflammation in men: a relevant atherothrombotic link. Heart 2007;93:940-944.
[PubMed]
34.
Jouven X, Empana JP, Schwartz PJ, Desmos M, Courbon D, Ducimeltiere P: Heart rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;152:1915-1958.
[PubMed]
35.
Jesen MT, Suadicani O, Hein HO, Gynderlberg F: Elevated resting heart rate, physical fitness and all-cause mortality: a 16-year follow-up in the Copenhagen Male Study. Heart 2013;99:882-887.
[PubMed]
36.
Gillman MW, Kannel WB, Belanger A, D'Agostino RB: Influence of heart rate on mortality among persons with hypertension: the Framingham Study. Am Heart J 1993;125:1148-1154.
[PubMed]
37.
Fox K, Borer JS, Camm J, Danchin N, Ferrari R, Sendon JLL, Steg PG, Tardif JC, Tavazzi L, Tendera M; Heart Rate Working Group: Resting heart rate in cardiovascular disease. J Am Coll Cardiol 2007;50:823-830.
[PubMed]
38.
Palatini P, Benetos A, Grassi G, Julius S, Kjeldsen SE, Mancia G, Narkiewicz K, Parati G, Pessina AC, Ruilope LM, Zanchetti A: Identification and management of the hypertensive patients with elevated heart rate: statement of the European Society of Hypertension consensus meeting. J Hypertens 2006;24:603-610.
[PubMed]
39.
Palatini P: Role of elevated hear rate in the development of cardiovascular disease in hypertension. Hypertension 2012;58:745-750.
[PubMed]
40.
Diaz A, Bourassa MG, Guertin MC, Tardif JC: Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005;26:967-974.
[PubMed]
41.
Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R; BEAUTIFUL Investigators: Heart rate as prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomized trial. Lancet 2008;372:817-821.
[PubMed]
42.
Kjekshus J: Comments - beta blockers: heart rate reduction a mechanism of benefit. Eur Heart J 1985;6(suppl. A):29-30.
43.
Hjalmarson A. Gilpin EA, Kjekshus J, Schieman G, Nicod P, Henning H, Ross J Jr: Influence of heart rate on mortality after acute myocardial infarction. Am J Cardiol 1990;65:547-553.
[PubMed]
44.
Boudoulas H: Therapeutic interventions which may improve survival in patients with coronary artery disease. Acta Cardiol 1990;45:477-487.
[PubMed]
45.
Beere PA, Glagov S, Zarins CK: Retarding effects of heart rate on coronary atherosclerois. Science 1984;226:180-184.
[PubMed]
46.
Schirmer SH, Degen A, Baumhakel M, Custodis F, Schuh L, Kohihaas M, Friedrich E, Bahlmann F, Kappl R, Maack C, Böhm M, Laufs U: Heart rate reduction by IF-channel inhibition with ivabradine restores collateral artery growth in hypercholesterolemic atherosclerosis. Eur Heart J 2011;33:1223-1231.
[PubMed]
47.
Borer JS, Fox K, Jailon P, Lerebours G: Antianginal and anti-ischemic effects of ivabradine, an I(f) inhibitor, in stable angina: a randomized, doubled-blind, multicentered, placebo-controlled trial. Circulation 2003;107:817-823.
[PubMed]
48.
Fox K, Ford I, Steg GP. Tendera M, Ferrari R; BEAUTIFUL Investigators: Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomized double-blind, placebo-controlled trial. Lancet 2008;372:807-816.
[PubMed]
49.
Fox K, Ford I, Steg GP, Tardif JC, Tendera M, Ferrari R; SIGNIFY Investigators: Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med 2014;371:1091-1099.
[PubMed]
50.
Fox K, Komajda M, Ford I, Robertson M, Böhm M, Borer JS, Steg GS, Tavazzi L, Tendera M, Ferrari R, Swedberg K: Effect of ivabradine in patients with left-ventricular systolic dysfunction: a pooled analysis of individual patients data from BEAUTIFUL and SHIFT trials. Eur Heart J 2013;34:2263-2270.
[PubMed]
51.
Manz M, Reuter M, Lauck G, Omran H, Jung W: A single intravenous dose of ivabradine, a novel If inhibitor, lowers heart rate but does not depress left ventricular function in patients with left ventricular dysfunction. Cardiology 2003;100:149-155.
[PubMed]
52.
Ferrari R: Ivabradine: heart rate and left ventricular function. Cardiology 2014;128:226-230.
[PubMed]
53.
Kolloch R, Legler UF, Champion A, Cooper-DeHoff RM, Handberg E, Zhou Q, Pepine CJ: Impact of resting heart rate on outcomes in hypertensive patients with coronary artery disease: findings from the International Verapamil-SR/Trandolapril Study (INVEST). Eur Heart J 2008;29:1327-1334.
[PubMed]
54.
Tsika EP, Poulimenos LE, Boudoulas KD, Manolis AJ: The J-curve in arterial hypertension: fact or fallacy? Cardiology 2014;129:126-135.
[PubMed]
55.
Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilberd EM, Shusterman NH: The effect of carvedilol on mortality and morbidity in patients with chronic heart failure. N Engl J Med 1996;334:1349-1355.
[PubMed]
56.
Lechat P, Hulot JS, Escolano S, et al: Heart rate and cardiac rhythm relationship with bisoptol benefit in chronic heart failure in the GIBIS II trial. Circulation 2001;103:1428-1433.
[PubMed]
57.
Hjalmarson A, Goldstein S, Fagerberg B, et al; MERIT-HF Study Group: Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL, Randomized Intervention Trial in Congestive Heart Failure (MERIT-II). JAMA 2000;283:1295-1302.
[PubMed]
58.
Dobre D, Borer JS, Fox K, Swedberg K, Adams KF, Clelard JGF, Cohen-Solal AS Chergrade M, Gueyffier FF, O'Connor CM, Fidzet M, Patak A, Pin I, Rozano G, Sebach HN, Tavazzi L, Zannad F: Heart rate: a prognostic factor and therapeutic target in chronic heart failure. The distinct roles of drugs with heart rate lowering properties. Eur J Heart Fail 2014;10:76-85.
[PubMed]
59.
Habal MV, Liu PP, Austin PC, Ross HJ, Newton GE, Wang X, Tu JV, Lee DS: Association of heart rate at hospital discharge with mortality and hospitalizations in patients with heart failure. Circ Heart Fail 2014;7:12-20.
[PubMed]
60.
Dobre D, Zannad F, Keteylan SJ, Stevens SR, Rossignol O, Kitzman DW, Landzberg J, Howlett J, Krauss WE, Ellis SJ: Association between resting heart rate, chronotropic index, and long term outcomes in patients with heart failure receiving β-blocker therapy: data from the HF-ACTION trial. Eur Heart J 2013;34:2271-2280.
[PubMed]
61.
Greene SJ, Vaduganathan M, Wilcox JE, Haristein ME, Maggioni AP, Subacius H, Zannad F, Konstam MA, Chioncel O, Yancy CW, Swedberg K, Butler J, Bonow RO, Gheorghiade M; EVEREST Investigators: The prognostic significance of heart rate in patients hospitalized for heart failure with reduced ejection fraction in sinus rhythm: insight from the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan) JACC Heart Fail 2013;1:488-496.
[PubMed]
62.
Shinbane JS, Wood MA, Jensen DN, Elenbogen KA, Fitzpatrick AP, Scheinman MM: Tachycardia induced cardiomyopathy: a review of animal models and clinical studies. J Am Coll Cardiol 1997;29:709-715.
[PubMed]
63.
Böhm M, Swedberg K, Komajda , Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L; SHIFT Investigators: Heart rate as a risk factor in chronic heart failure (SHIFT). The association between heart rate and outcomes in a randomized placebo-controlled trial. Lancet 2010;376:886-894.
[PubMed]
64.
Reil JC, Tardif JC, Ford I, Lloyd SM, O'Meara E, Komajda M, Borer JF, Tavazzi L, Swedberg K, Böhm M: Selective heart rate reduction with ivabradine unloads the left ventricle in heart failure patients. J Am Coll Cardiol 2013;62:1977-1985.
[PubMed]
65.
De Ferrari GM, Mazzuero A, Argesina I, et al: Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. Eur Heart Fail 2008;10:550-555.
[PubMed]
66.
Ekman I, Chassany O, Komajda M, Böhm M, Borer JS, Ford I, Tavazzi L, Swedberg K: Heart rate reduction with ivabradine and health related quality of life in patients with chronic heart failure: results from the SHIFT study. Eur Heart J 2011;32:2395-2404.
[PubMed]
67.
Tardif JC, O'Meara E, Komajda M, Böhm M, Borer JS, Ford I, Tavazzi L, Swedberg K; SHIFT Investigators: Effects of selective heart rate reduction with ivabradine on left ventricular remodeling and function: results from the SHIFT echocardiographic substudy. Eur Heart J 2011;32:2507-2515.
[PubMed]
68.
Dyer AR, Persky V, Stamler J, et al: Heart rate as a prognostic factor for coronary heart disease and mortality: findings in Chicago epidemiologic studies. Am J Epidemiol 1980;112:736-749.
[PubMed]
69.
Williams B, Lacy PS; ASCOT Investigators: Impact of heart rate on central aortic pressure and hemodynamics: analysis from the CAFÉ (Conduit Artery Function Evaluation) study. J Am Coll Cardiol 2009;54:705-713.
[PubMed]
70.
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE: Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 1993;329:1677-1168.
[PubMed]
71.
Tardif JC, Polikowski O, Kahan T: Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J 2009;30:540-548.
[PubMed]
72.
Borer JS, Böhm M, Ford I, Robertson M, Komajda M, Tavazzi L, Swedberg K: Efficacy and safety of ivabradine in patients with severe chronic systolic heart failure (from the SHIFT study). J Am Coll Cardiol 2014;113:497-503.
[PubMed]
73.
Dierckx R, Cleland JGF, Parsons S, Putzu P, Pellicori P, Dicken B, Boyalla V, Clark AL: Prescribing patterns to optimize heart failure rate: analysis of 1,000 consecutive outpatient appointments to a single heart failure clinic over a six-month period. JACC Heart Fail 2015;3:224-230.
[PubMed]
74.
Borer JS: Heart rate slowing by If inhibition: therapeutic utility from clinical trials. Eur Heart J 2005;7(suppl H):H22-H28.
75.
Boudoulas KD, Leier CV, Geleris P, Boudoulas H: Shortcoming of guidelines. Cardiology 2015;130:187-200.
[PubMed]
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