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Time-updated resting heart rate predicts mortality in patients with COPD

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Abstract

High resting heart rate (RHR) is associated with higher mortality in the general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). In particular, the time-updated RHR (most recent value before the event) appears informative. This is the first study to investigate the association of time-updated RHR with mortality in COPD. We compared the baseline and time-updated RHR related to survival in 2218 COPD patients of the German COSYCONET cohort (COPD and Systemic Consequences—Comorbidities Network). Patients with a baseline RHR > 72 beats per minute (bmp) had a significantly (p = 0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00–1.87) compared to baseline RHR ≤ 72 bpm. The time-updated RHR > 72 bpm was markedly superior (HR 1.79, 1.30–2.46, p = 0.001). Both, increased baseline and time-updated RHR, were independently associated with low FEV1, low TLCO, a history of diabetes, and medication with short-acting beta agonists (SABAs). In conclusion, increased time-updated RHR is associated with higher mortality in COPD independent of other predictors and superior to baseline RHR. Increased RHR is linked to lung function, comorbidities and medication. Whether RHR is an effective treatment target in COPD, needs to be proven in controlled trials.

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Acknowledgments

This work was supported by the German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET). The project is funded by the BMBF with Grant number 01 GI 0881, and is supported by unrestricted Grants from AstraZeneca GmbH, Bayer Schering Pharma AG, Boehringer Ingelheim Pharma GmbH & Co. KG, Chiesi GmbH, GlaxoSmithKline, Grifols Deutschland GmbH, MSD Sharp & Dohme GmbH, Mundipharma GmbH, Novartis Deutschland GmbH, Pfizer Pharma GmbH, Takeda Pharma Vertrieb GmbH & Co. KG for patient investigations and laboratory measurements. The funding body had no involvement in the design of the study, or the collection, analysis or interpretation of the data. MB is supported by the Transregio SFB-TTR 219 S-01 of the Deutsche Forschungsgemeinschaft.

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Authors and Affiliations

  1. Department of Internal Medicine V – Pulmonology, Allergology, Critical Care Medicine, Saarland University Medical Centre, Saarland University Hospital, 66421, Homburg/Saar, Germany

    Albert J. Omlor, Franziska C. Trudzinski, Mohamad Alqudrah, Frederik Seiler, Sebastian Fähndrich & Robert Bals

  2. Institute for Biostatistics, Hannover Medical School, Hannover, Germany

    Frank Biertz

  3. Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg (UMR), Marburg, Germany

    Claus F. Vogelmeier & Peter Alter

  4. Clinic for Pneumology, Hannover Medical School, Hannover, Germany

    Tobias Welte

  5. Airway Research Center North, Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany

    Henrik Watz & Benjamin Waschki

  6. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany

    Benjamin Waschki

  7. Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany

    Titus J. Brinker

  8. Lungenfachklinik Immenhausen, Immenhausen, Germany

    Stefan Andreas

  9. Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Göttingen, Germany

    Stefan Andreas

  10. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany

    Rudolf A. Jörres

  11. Department of Internal Medicine III – Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Saarland University, Homburg, Germany

    Michael Böhm

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  1. Albert J. Omlor
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  2. Franziska C. Trudzinski
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  3. Mohamad Alqudrah
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German COSYCONET Cohort

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Correspondence to Robert Bals.

Additional information

C. F. Vogelmeier, P. Alter, T. Welte, H. Watz, B. Waschki: Members of the German Center for Lung Research (DZL).

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Omlor, A.J., Trudzinski, F.C., Alqudrah, M. et al. Time-updated resting heart rate predicts mortality in patients with COPD. Clin Res Cardiol 109, 776–786 (2020). https://doi.org/10.1007/s00392-019-01572-1

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