Elevated heart rate (HR) is associated with higher mortality and morbidity in patients with heart failure (HF). This study is aimed to evaluate the clinical significance of heart rate in predicting the prognosis in patients with chronic heart failure (CHF).

We enrolled 1581 consecutive CHF (mean age 68.1 years) registered in the Therapeutic Unit of Chronic Heart Failure. We divided the patients into 2 groups: group 1 with HR≤70 bpm, group 2 with HR >70 bpm. The relationships between HR and the prognosis of CHF patients were determined.

Elevated HR was associated with male sex, hypertension, diabetes, strock attack and ischemic heart disease, but the association was modest with obesity. CHF patients with NYHA grade III/IV had higher HR than those with NYHA grade I/II with a good correlation. Hight HR correlated with increased cardiac decompensation and hospitalizations (p<0.0001), elevated filling pressure (p<0.0001). Also, there were statistical differences in atrial fibrillation between the group 1 and 2. Furthermore, ?-Blocker therapy and Ivabradine were associated with reduced HR (p<0.0001). We also observed negative correlations between HR and hemoglobin, glomerular filtration rate (GFR) were also found.

Elevated HR was associated with increased cardiac decompensation and hospitalization. It may have good clinical predictive value in patients with CHF and should be a distinct therapeutic target.