It is well known that increased resting heart rate is associated with increased mortality not only from cardiovascular disease but also from non-cardiovascular disease. Few clinical studies have examined whether resting heart rate is associated with left heart insufficiency and/or heart failure in asymptomatic patients without a history of cardiovascular disease. Opdahl A. et al. of Johns Hopkins University School of Medicine conducted the MESA study (Multi-Ethnic Study of Atherosclerosis) to assess the association of baseline resting heart rate with heart failure and total or left heart insufficiency. The investigators measured the resting heart rate of patients participating in the MESA study at the time of inclusion. After a mean follow-up of 7 years, heart failure occurred in 176 of the 5,000 patients who underwent cardiac magnetic resonance examination. A total of 1056 patients underwent testing for ejection fraction (ΔEF) and peak circumferential strain change (Δεcc) at baseline and year 5, and this was used as an index to assess whole-heart or left-heart dysfunction. A 4% increase in the corrected relative risk of heart failure events was found for each 1 beat/minute increase in resting heart rate. A corrected multiple regression analysis model showed that resting heart rate was positively associated with a decrease in Δ?εcc and ΔEF, even after all coronary events were excluded. The study concluded that an accelerated resting heart rate in participants without symptoms of heart failure was associated with an increased risk of heart failure events, that an accelerated heart rate was associated with progression of whole-heart or left-heart dysfunction, and that this relationship was independent of subclinical atherosclerosis and coronary artery disease.