{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T11:10:04Z","timestamp":1769080204894,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":573,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Sino-German Center for Research Promotion\/Chinesisch-Deutsches Zentrum f\u00fcr Wissenschaftsf\u00f6rderung","award":["GZ 1659"],"award-info":[{"award-number":["GZ 1659"]}]},{"name":"National Key R&D Program of the Ministry of Science and Technology of China","award":["2018YFE0103000"],"award-info":[{"award-number":["2018YFE0103000"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The benefits of lowering heart rate (HR) in heart failure (HF) with preserved ejection fraction (HFpEF) patients are still a matter of debate. This study aimed to investigate the relationship between changes in HR during hospitalization and cardiovascular (CV) events and all-cause death in hospitalized HFpEF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Hospitalized HF patients between January 2017 and December 2021 were consecutively enrolled in a national, multicentred, and prospective registry database, the China Cardiovascular Association Database-HF Center Registry. HF patients with a left ventricular ejection fraction of \u226550% were defined as HFpEF patients. The study analysed admission\/discharge HR, change in HR during hospitalization (\u2206HR), and \u2206HR ratio (\u2206HR\/admission HR). The patients were categorized into three groups: no HR dropping group (\u0394HR ratio &amp;gt; 0.0%), moderate HR dropping group (\u221215% &amp;lt; \u0394HR ratio \u2264 0.0%), and excessive HR dropping group (\u0394HR ratio \u2264 \u221215%). All patients were followed up for 12 months. The primary endpoint was CV events (CV death or HF rehospitalization). The secondary endpoint was all-cause death. A total of 19 510 HFpEF patients (9750 males, mean age 71.9 \u00b1 12.2 years) were included, with 4575 in the no HR dropping group, 8434 in the moderate HR dropping group, and 6501 in the excessive HR dropping group. Excessive HR dropping during hospitalization was significantly associated with an increased risk of CV events (17.1%) compared with the no HR dropping group (14.5%, P &amp;lt; 0.001) or the moderate HR dropping group (14.0%, P &amp;lt; 0.001), although all-cause mortality was similar among the three groups. After adjusting for multiple confounding factors, excessive HR dropping remained an independent predictor of increased CV event risk [hazard ratio 1.197, 95% confidence interval (CI) 1.078\u20131.328]. Subgroup analysis revealed that the prognostic impact of excessive HR dropping on increased CV event risk remained in the subgroups of older age, New York Heart Association class IV, ischaemic HF, higher left ventricular ejection fraction, absence of chronic kidney disease, and use of beta-blockers or ivabradine. Independent determinants associated with excessive HR dropping during admission included use of beta-blockers [odds ratio (OR) 1.683, 95% CI 1.558\u20131.819], lower discharge diastolic blood pressure (OR 0.988, 95% CI 0.985\u20130.991), no pacemaker (OR 0.501, 95% CI 0.416\u20130.603), coexisting atrial fibrillation or atrial flutter (OR 1.327, 95% CI 1.218\u20131.445), and use of digoxin (OR 1.340, 95% CI 1.213\u20131.480).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In hospitalized HFpEF patients, excessive HR dropping during hospitalization is associated with an increased risk of CV death or HF rehospitalization. These findings highlight the importance of HR monitoring and avoiding excessively slowing down HR in hospitalized HFpEF patients to reduce the risk of CV events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14721","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T01:19:41Z","timestamp":1711070381000},"page":"2901-2912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Heart Rate Changes During Hospitalization on Outcome in Heart Failure with Preserved Ejection Fraction"],"prefix":"10.1093","volume":"11","author":[{"given":"Dan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Internal Medicine I, Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg , Oberd\u00fcrrbacher Str. 6, W\u00fcrzburg, 97080 ,","place":["Germany"]},{"name":"Comprehensive Heart Failure Center , W\u00fcrzburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-7824","authenticated-orcid":false,"given":"Xiaotong","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhonglei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanli","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jinshan Hospital of Fudan University , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-4068","authenticated-orcid":false,"given":"Peter","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Internal Medicine I, Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg , Oberd\u00fcrrbacher Str. 6, W\u00fcrzburg, 97080 ,","place":["Germany"]},{"name":"Comprehensive Heart Failure Center , W\u00fcrzburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiefu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Geriatric Medicine, National Center of Gerontology, Beijing Hospital, Chinese Academy of Medical Sciences , Da Hua Road 1, Dong Dan, Beijing, 100730 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingmin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9360-7332","authenticated-orcid":false,"given":"Junbo","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University , Fenglin Road 180, Shanghai, 200032 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