Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis)

Anders Opdahl, Bharath Ambale Venkatesh, Veronica R.S. Fernandes, Colin O. Wu, Khurram Nasir, Eui Young Choi, Andre L.C. Almeida, Boaz Rosen, Benilton Carvalho, Thor Edvardsen, David A. Bluemke, João A.C. Lima

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


Objectives The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction. Background The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population. Methods Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion. Incident HF was registered (n = 176) during follow-up (median 7 years) in those who underwent cardiac magnetic resonance imaging (n = 5,000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1,056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume, and mass in addition to resting heart rate. Results Cox analysis demonstrated that for 1 beat/min increase in resting heart rate, there was a 4% greater adjusted relative risk for incident HF (hazard ratio: 1.04; 95% CI: 1.02 to 1.06; p < 0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even when all coronary heart disease events were excluded from the model. Conclusions Elevated resting heart rate was associated with increased risk for incident HF in asymptomatic participants in the MESA trial. Higher heart rate was related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487).

Original languageEnglish (US)
Pages (from-to)1182-1189
Number of pages8
JournalJournal of the American College of Cardiology
Issue number12
StatePublished - Apr 1 2014


  • cardiac MRI
  • coronary heart disease
  • heart failure
  • left ventricular dysfunction
  • myocardial strain
  • resting heart rate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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