{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:35:46Z","timestamp":1793414146778,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,2,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Many hospitalized patients with heart failure and reduced ejection fraction (\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              r\n              <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>\n              ) have a slow heart rate at discharge, and the effect of \u03b2\u2010blockers may be reduced in those patients. We sought to examine the variable effect of \u03b2\u2010blockers on clinical outcomes according to the discharge heart rate of hospitalized\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              r\n              <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>\n              patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The KorAHF (Korean Acute Heart Failure) registry consecutively enrolled 5625 patients hospitalized for acute heart failure. In this analysis, we included patients with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              r\n              <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>\n              (left ventricular ejection fraction \u226440%).\n              <jats:italic>Slow heart rate<\/jats:italic>\n              was defined as &lt;70\u00a0beats per minute regardless of the use of \u03b2\u2010blockers. The primary outcome was 1\u2010year all\u2010cause postdischarge death according to heart rate. Among 2932 patients with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              r\n              <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>\n              , 840 (29%) had a slow heart rate and 56% received \u03b2\u2010blockers at discharge. Patients with slow heart rates were older and had lower 1\u2010year mortality than those with high heart rates (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). A significant interaction between discharge heart rate and \u03b2\u2010blocker use was observed (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for interaction). When stratified, only patients without a \u03b2\u2010blocker prescription and with a high heart rate showed higher 1\u2010year mortality. In a Cox\u2010proportional hazards regression analysis, \u03b2\u2010blocker prescription at discharge was associated with 24% reduced risk for 1\u2010year mortality in patients with high heart rates (hazard ratio: 0.76; 95% CI, 0.61\u20130.95) but not in those with slow heart rates (hazard ratio: 1.02; 95% CI, 0.68\u20131.55).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Many patients with acute heart failure have slow discharge heart rates, and \u03b2\u2010blockers may have a limited effect on\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              r\n              <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>\n              and slow discharge heart rate.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrial.gov\">http:\/\/www.clinicaltrial.gov<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01389843.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.011121","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T10:16:56Z","timestamp":1550053016000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["\u03b2\u2010Blockers and 1\u2010Year Postdischarge Mortality for Heart Failure and Reduced Ejection Fraction and Slow Discharge Heart Rate"],"prefix":"10.1161","volume":"8","author":[{"given":"Jin Joo","family":"Park","sequence":"first","affiliation":[{"name":"Division of Cardiology Cardiovascular Center Seoul National University Bundang Hospital Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Ah","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Inje University Seoul Paik Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Jai","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae\u2010Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kye Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Heart Research Center of Chonnam National University Gwangju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung\u2010Su","family":"Yoo","sequence":"additional","affiliation":[{"name":"Yonsei University Wonju College of Medicine Wonju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok\u2010Min","family":"Kang","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hong","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun\u2010Seok","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sungkyunkwan University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Joong","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Asan Medical Center Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myeong\u2010Chan","family":"Cho","sequence":"additional","affiliation":[{"name":"Chungbuk National University College of Medicine Cheongju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shung Chull","family":"Chae","sequence":"additional","affiliation":[{"name":"Kyungpook National University College of Medicine Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung\u2010Hee","family":"Oh","sequence":"additional","affiliation":[{"name":"Mediplex Sejong Hospital Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Ju","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiovascular Center Seoul National University Bundang Hospital Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052256"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605233342101"},{"key":"e_1_3_1_4_2","first-page":"64","article-title":"Heart rate as a therapeutic target in heart failure","volume":"1","author":"Kjekshus J","year":"1999","unstructured":"Kjekshus J, Gullestad L. Heart rate as a therapeutic target in heart failure. Eur Heart J Suppl. 1999;1:64\u201369.","journal-title":"Eur Heart J Suppl"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.031"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.032"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.91"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2016.0419"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61198-1"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61171-X"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yjmcc.2015.02.003"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv087"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000139336.69955.AB"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.10.1428"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi386"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118464.48959.1C"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.103.059717"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2009.09.002"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1054\/jcaf.2001.22491"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs060"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.001"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.05.076"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.05.054"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.044"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:CEPR.0000012389.01561.27"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61373-8"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2012.09.002"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.346"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.011121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:51:26Z","timestamp":1715601086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.011121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,19]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,2,19]]}},"alternative-id":["10.1161\/JAHA.118.011121"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.011121","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,19]]},"assertion":[{"value":"2018-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011121"}}