Davos 2011- From angina pectoris to heart failure management
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Prof. François Mach, MD Divison of Cardiology Geneva University Hospital [email protected] www.cardiology-geneva.ch Satellite Symposium Servier Davos, February 15, 2011 From Angina Pectoris to Heart Failure Management Cardiology Update 2011
Transcript of Davos 2011- From angina pectoris to heart failure management
Prof. François Mach, MDDivison of Cardiology
Geneva University [email protected]
www.cardiology-geneva.ch
Satellite Symposium Servier
Davos, February 15, 2011
From Angina Pectoris to Heart Failure Management
Cardiology Update 2011
Cheval
ElephantLion
Chien
Chat
Âne
Singe
Souris
Hamster
1000
500
300
100
50
20
5 10 15 20 25 30
Fré
qu
en
ce
ca
rdia
qu
e d
e r
ep
os
(ba
tte
me
nts
/min
)
Espérance de vie (années)
35 40 80 100
Baleine
Rat
Marmotte
TigreGirafe
J Am Coll Cardiol 1997;30:1104
100
50
30
10
5
2
102 104 106 108 1010 1012
Baleine
ChevalElephantLion
Chien ChatÂne
GirafeSinge
Tigre
Marmotte
Rat
Battements / vie
SourisHamster
Esp
éra
nc
e d
e v
ie
(an
né
es)
Number of heart beat per life 9 x 108
Heart rate and life expectancy in animals
p=0.0001
Follow-up(years)
1 5 10 15 20
100%
90%
80%
70%
Su
rviv
al
HR <60 bpm
60< HR <80 bpm
80 < HR <100 bpm
HR >100 bpm
19’386 subjets - “Check-up”
HR pby ECG
Mean follow-up: 18.2 years
Heart rate and life expectancy in general population
• 5713 men
N Eng J Med 2005;352:1951
• Mean follow-up 23 years
Heart rate and life expectancy in general population
0.0
17.5
35.0
52.5
70.0
< 64 65-74 75-84 >85/min
Heart Failure
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
Sudden death
Eve
nts
/1000 p
atie
nts
♂ 35-84 y.o.♂ 66-94 y.o.
Eve
nts
/1000 p
atie
nts
15
25
48
63
80-8766-73 74-7965 >88/min
1.1
2.5
3.1
4.7
5.9
• 5070 individuals • Mean follow-up 30 years
Heart rate and life expectancy in general population
•24 913 patients
Eur Heart J 2005;26:867
•Median follow-up was 14.7 years
Heart rate and life expectancy in CAD patients
DIAMOND Study; 1518 patients with HF post IM, 10 years follow up
P<0.0001
0 2 4 6 8 10Years
1.0
0.8
0.4
0.0
0.6
0.2
> 91 bpm81-91 bpm71-80 bpm40-70 bpm
Mortality
Int J Cardiol, 2010;140:279
Resting heart rate and mortality in HF post MI
Efficacy of BB related to HR decrease and not dosage
" Life begins with the first heart beat, and ends
with the last one "
Aristote 384 – 322 before J.C.
