Decreased Heart Rate Recovery in Patients With Heart Failure Effect of Fluvastatin Therapy

Abstract

SUMMARYHeart rate recovery is the difference in heart rate at peak exercise and at a specific time interval following the onset of recovery. Attenuated heart rate recovery is an independent predictor of mortality in patients with a history of coronary artery disease. The aim of the present study was to evaluate the effect of a statin on heart rate recovery, particularly in patients with ischemic heart failure and hyperlipidemia. Twenty-nine consecutive hyperlipidemic, stable coronary artery disease patients with heart failure and 19 healthy subjects were enrolled. Heart rate recovery values at the 1st and 3rd minutes and lipid profiles of the patients were evaluated at baseline and following 3 months of treatment with fluvastatin. Compared with healthy subjects, the heart rate recovery values were significantly lower in the heart failure patients in both the 1st and 3rd minutes, respectively (31 ± 6 versus 19 ± 7, P < 0.0001; 66 ± 7 versus 47 ± 8, P < 0.0001). Heart rate recovery in the 1st and 3rd minutes increased from 19 ± 7 to 24 ± 9 and 47 ± 8 to 57 ± 11, respectively, following treatment (P < 0.001, P < 0.001). There were no significant correlations among the changes in lipid parameters or HRR in the first and third minutes in the recovery period. The results revealed an improvement in heart rate recovery in heart failure patients by fluvastatin treatment. If this association can be confirmed by other studies, it would be interesting to perform further studies into the mechanism underlying this finding. (Int Heart J 2005; 46: 845-854)

Short-term effects of fluvastatin therapy on plasma interleukin-10 levels in patients with chronic heart failure

“…Heart rate recovery (HRR) was calculated as the difference between heart rate at peak exercise and heart rate at the relevant minute of recovery. Exercise test findings of this population were reported earlier [12].…”

“…In this context, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, statins, were propounded in HF by their ability to downregulate inflammatory cytokines [6][7][8], improve endothelial function [9], reverse myocardial remodeling [10], and provide salutary neural effects [11,12]. The effects of these agents to improve clinical outcomes in HF patients, however, remain controversial [13][14][15][16][17][18][19].…”

Association of metabolic syndrome with impaired heart rate recovery and low exercise capacity in young male adults

“…Recent studies have shown that medical treatment with different agents (e.g. beta blockers, statins) might affect HRR 33 . Treatment of patients with metabolic syndrome via beta blockers, statins, and weight reduction via diet, exercise and pharmacological anti‐obesity agents may ensure improvement in autonomic functions which may be determined with HRR analysis.…”

Statins and the autonomic nervous system

“…The significance of this finding is unknown in so far as there is an inverse relationship between MSNA and LF spectral power as heart failure progresses [108], and in a multivariate analysis involving heart failure patients reduced daytime LF power of HR was an independent predictor of increased risk of sudden cardiac death [109]. In a controlled study, 3 months of fluvastatin (80 mg/day) reduced total cholesterol and LDL-cholesterol, and increased HR recovery at 1 and 3 min following a maximal exercise test in 29 hyperlipidaemic patients with ischaemic cardiomyopathy (LVEF <40 %) [110].…”