Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
J Am Coll Cardiol. 2011 Oct 18;58(17):1795-803. doi: 10.1016/j.jacc.2011.06.055.
The aim of this study was to investigate the influence of rate control on quality of life (QOL).
The RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation II) trial showed that lenient rate control is not inferior to strict rate control in terms of cardiovascular morbidity and mortality. The influence of stringency of rate control on QOL is unknown.
In RACE II, a total of 614 patients with permanent atrial fibrillation (AF) were randomized to lenient (resting heart rate [HR] <110 beats/min) or strict (resting HR <80 beats/min, HR during moderate exercise <110 beats/min) rate control. QOL was assessed in 437 patients using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire, AF severity scale, and Multidimensional Fatigue Inventory-20 (MFI-20) at baseline, 1 year, and end of study. QOL changes were related to patient characteristics.
Median follow-up was 3 years. Mean age was 68 ± 8 years, and 66% were males. At the end of follow-up, all SF-36 subscales were comparable between both groups. The AF severity scale was similar at baseline and end of study. At baseline and at end of study there were no differences in the MFI-20 subscales between the 2 groups. Symptoms at baseline, younger age, and less severe underlying disease, rather than assigned therapy or heart rate, were associated with QOL improvements. Female sex and cardiovascular endpoints during the study were associated with worsening of QOL.
Stringency of heart rate control does not influence QOL. Instead, symptoms, sex, age, and severity of the underlying disease influence QOL. (Rate Control Efficacy in Permanent Atrial Fibrillation; NCT00392613).
本研究旨在探讨心率控制对生活质量（QOL）的影响。
RACE II（Rate Control Efficacy in Permanent Atrial Fibrillation II）试验表明，宽松的心率控制在心血管发病率和死亡率方面并不逊于严格的心率控制。严格控制心率对 QOL 的影响尚不清楚。
在 RACE II 中，共有 614 名永久性房颤（AF）患者被随机分为宽松组（静息心率[HR]＜110 次/分）或严格组（静息 HR＜80 次/分，中度运动时 HR＜110 次/分）。使用 Medical Outcomes Study 36-item Short-Form Health Survey（SF-36）问卷、AF 严重程度量表和多维疲劳量表-20（MFI-20）在基线、1 年和研究结束时评估 437 名患者的 QOL。QOL 变化与患者特征相关。
中位随访时间为 3 年。平均年龄为 68±8 岁，66%为男性。随访结束时，两组 SF-36 各维度得分均相似。基线和研究结束时，AF 严重程度量表相似。基线和研究结束时，两组间 MFI-20 各维度得分均无差异。基线症状、年龄较小和基础疾病较轻，而不是所接受的治疗或心率，与 QOL 改善相关。女性和研究期间的心血管终点与 QOL 恶化相关。
心率控制的严格程度不会影响 QOL。相反，症状、性别、年龄和基础疾病的严重程度会影响 QOL。（永久性房颤的心率控制效果；NCT00392613）。
