In this prospective observational study of 143 consecutive STEMI patients, HR was measured serially on admission (AHR), at day 1 (HRd1) and 2 (HRd2) following revascularization and finally at discharge (DHR). Cardiac magnetic resonance (CMR) scans were performed at baseline and 4 months thereafter to evaluate LVR and major CMR determinants of LVR (infarct size, microvascular obstruction). LVR was defined as ≥ 15% increase of left ventricular end-diastolic volume.
Twenty-nine patients (20%) have developed LVR. HRd1 (80[72–88] vs. 71[62–79]bpm, p = 0.003), HRd2 (74[64–83] vs. 67[59–78]bpm, p = 0.04), DHR (74[62–81] vs. 64[58–73] bpm, p = 0.008) and the mean HR of all measurements (76[68–82] vs. 67[60–77]bpm, p = 0.004) were significantly higher in patients with LVR, whereas admission HR (75[68–85] vs. 70[60–82]bpm, p = 0.12) did not differ significantly. The associations for all post-admission HRs remained significant after adjustment for clinical (high-sensitivity cardiac troponin T and C-reactive protein, left anterior descending artery as culprit) and CMR (infarct size, microvascular obstruction, ejection fraction) predictors of LVR. The predictive values of the post-admission HRs were equivalent (area under the curve differences: all p > 0.05).
Besides DHR, resting HR values in the early stage following reperfusion are independent predictors of LVR after STEMI.