Herzfrequenz: klinische Variable und Risikomarker

Zusammenfassung

Die Herzfrequenz ist eine einfache klinische Variable mit weitreichender prognostischer Bedeutung. Eine unter Ruhebedingungen erhöhte Herzfrequenz ist mit einem erhöhten kardiovaskulären Risiko verknüpft. Daten epidemiologischer Studien demonstrieren sowohl für Personen ohne bekannte kardiovaskuläre Erkrankungen sowie für Individuen mit bestehenden kardiovaskulären Erkrankungen wie arterieller Hypertonie, koronarer Herzerkrankung (KHK) und chronischer Herzinsuffizienz eine relevante Assoziation zwischen der Höhe der Herzfrequenz und der mittleren Überlebenszeit. Während eine gezielte medikamentöse Herzfrequenzreduktion im Rahmen der Primärprävention bislang keine Rolle spielt, ist sie bei Patienten mit KHK und chronischer Herzinsuffizienz von wesentlicher symptomatischer und prognostischer Bedeutung. Für die Herzinsuffizienz und möglicherweise auch die KHK ist die Herzfrequenz darüber hinaus als unabhängiger Risikofaktor anzusehen. Demnach weisen die Leitlinien eine Reduktion der Herzfrequenz als Therapieziel der medikamentösen Behandlung aus.

Abstract

Heart rate is an easily accessible clinical variable with wide-ranging prognostic impact. Elevated resting heart rate predicts an elevated cardiovascular risk. Epidemiological studies demonstrate a relevant association between heart rate and survival in individuals without diagnosed cardiovascular disease and with cardiovascular disease like hypertension, coronary artery disease (CAD) and heart failure. Whereas a goal directed pharmacological heart rate reduction is not supported by clinical evidence for primary prevention it plays a prognostic role for patients with CAD and chronic heart failure. Moreover heart rate can be characterized as an independent risk factor for patients with heart failure and potentially for those with CAD. As a result the common guidelines recommend heart rate reduction as a target of therapy.

Schlüsselwörter

Herzfrequenz - kardiovaskuläres Risiko - Risikomarker - Risikofaktor

Keywords

heart rate - cardiovascular risk - risk marker - risk factor

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