Prognostic Value of the Change in Heart Rate From the Supine to the Upright Position in Patients With Chronic Heart Failure

Background-The prognostic value of the change in heart rate from the supine to upright position (Delta HR) in patients with chronic heart failure (HF) is unknown. Methods and Results-Delta HR was measured in patients enrolled in the Trial of Intensified Medical Therapy in Elderly Patients with Congestive Heart Failure (TIME-CHF) who were in sinus rhythm and had no pacemaker throughout the trial (n=321). The impact of Delta HR on 18-month outcome (HF hospitalization-free survival) was assessed. In addition, the prognostic effect of changes in Delta HR between baseline and month 6 on outcomes in the following 12 months was determined. A lower Delta HR was associated with a higher risk of death or HF hospitalization (hazard ratio 1.79 [95% confidence interval {95% CI} 1.19-2.75] if Delta HR