M.I. Lutai Heart rate and heart failure. A view of the clinician.

Currently there is no doubt that elevated heart rate (HR) at rest is an indicator of poor prognosis in patients with IHD and heart failure, but the range of safe level of HR for these patients has yet to be established. It is suggested that the level of HR reduction in these patients should be the primary criteria of drugs dosage that affects HR (Β-blockers, angiotensin-converting enzyme inhibitors, If-channels). Also, it has been determined that the appropriate lower boundary of HR reduction correlates with severity of hemodynamic disorders. Based on recent data from meta-analysis studies using beta-blockers and SHIFT study, it is suggested that the upper HR boundary should be in the range of 80–85 bpm and the lower boundary should be in the range of 65–70 bpm for patients with moderate to severe systolic HF.

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