Why reduce heart rate in patients with chronic heart failure?

Abstract

Indeed, why ? After all, heart rate (HR) increase is a natural adaptive response of the organism to a decrease in stroke volume of the left ventricle. It is due to the increase in HR that in patients with low cardiac output the minute volume of blood (MVB) remains normal. On the other hand, heart rate increase leads to growing myocardial oxygen demand and accelerates exhaustion of its contractile reserve. Heart rate elevation is especially beneficial for patients with coronary heart disease (CHD) with a high risk of acute and progression of chronic myocardial ischemia, subsequent exacerbation of systolic dysfunction. Furthermore, patient-specific critical value of HR elevation is no longer a compensation and adaptation mechanism; it causes stroke volume to reduce following a decrease in ventricular filling due to diastolic shortening.