Objectives: Reduction of resting heart rate (HR) has been suggested as a novel therapeutic approach in patients with chronic heart failure because it has been shown to prolong survival and also to improve health-related quality of life (Hr-QoL). The purpose of this analysis was to assess the prognostic impact of resting HR in patients with dilated cardiomyopathy (DCM).
Methods: 217 patients with DCM confirmed by endomyocardial biopsy were investigated (age 49 ± 11 years, 20.7 % were female). The study population was divided into two groups according to the median of the resting HR. After a median follow-up time of 7.4 years overall survival and health-related quality of life (Hr-QoL) were compared in both groups. Survival was compared using Kaplan-Meier method and Hr-QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
Results: Elevated resting HR was associated with poor 1-year survival (p = 0.03). In contrast, long-term survival was not affected by HR (p = 0.20). Patients with lower HR at rest scored significantly lower on the MLHFQ (20 vs. 36, p = 0.03), indicating that higher resting HR is associated with an impairment of Hr-QoL.
Conclusions: Increased HR might be used as a diagnostic tool to identify patients at risk. Reduction of resting HR in patients with DCM might be a therapeutic option to improve Hr-QoL and therefore merits further investigation in future studies.