Prognostic utility of pulse pressure in patients with heart failure with preserved ejection fraction: The RICA Registry.
Arterial stiffness
Fracción de eyección del ventrículo izquierdo
Heart failure
Left ventricular ejection fraction
Mortalidad
Mortality
Presión de pulso
Pulse pressure
Rigidez arterial
insuficiencia cardiac
Journal
Revista clinica espanola
ISSN: 2254-8874
Titre abrégé: Rev Clin Esp (Barc)
Pays: Spain
ID NLM: 101632437
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
22
11
2022
accepted:
31
01
2023
medline:
11
4
2023
pubmed:
20
3
2023
entrez:
19
3
2023
Statut:
ppublish
Résumé
The prognostic role of pulse pressure (PP) in heart failure (HF) patients with preserved left ventricular ejection fraction (LVEF) is not well understood. Our aim was to evaluate it in acute and stable HF. This work is a retrospective observational study of patients included in the RICA registry between 2008 and 2021. Blood pressure was collected on admission (decompensation) and 3 months later on an outpatient basis (stability). Patients were categorized according to whether the PP was greater or less than 50mmHg. All-cause mortality was assessed at 1year after admission. A total of 2291 patients were included, with mean age 80.1±7.7 years. 62.9% were women and 16.7% had a history of coronary heart disease. In the acute phase, there was no difference in mortality according to PP values, but in the stable phase PP<50mmHg was independently associated with all-cause mortality at 1-year follow-up (HR 1.57, 95% CI 1.21-2.05, p=0.001), after adjusting for age, sex, New York Heart Association functional class, previous HF, chronic kidney disease, valvular heart disease, cerebrovascular disease, score on the Barthel and Pfeiffer scales, hemoglobin and sodium levels. Low stable-phase PP was associated with increased all-cause mortality in HF patients with preserved LVEF. However, PP was not useful as a prognostic marker of mortality in acute HF. Further studies are needed to assess the relationship of this variable with mortality in HF patients.
Sections du résumé
BACKGROUND AND AIMS
The prognostic role of pulse pressure (PP) in heart failure (HF) patients with preserved left ventricular ejection fraction (LVEF) is not well understood. Our aim was to evaluate it in acute and stable HF.
MATERIAL AND METHODS
This work is a retrospective observational study of patients included in the RICA registry between 2008 and 2021. Blood pressure was collected on admission (decompensation) and 3 months later on an outpatient basis (stability). Patients were categorized according to whether the PP was greater or less than 50mmHg. All-cause mortality was assessed at 1year after admission.
RESULTS
A total of 2291 patients were included, with mean age 80.1±7.7 years. 62.9% were women and 16.7% had a history of coronary heart disease. In the acute phase, there was no difference in mortality according to PP values, but in the stable phase PP<50mmHg was independently associated with all-cause mortality at 1-year follow-up (HR 1.57, 95% CI 1.21-2.05, p=0.001), after adjusting for age, sex, New York Heart Association functional class, previous HF, chronic kidney disease, valvular heart disease, cerebrovascular disease, score on the Barthel and Pfeiffer scales, hemoglobin and sodium levels.
CONCLUSIONS
Low stable-phase PP was associated with increased all-cause mortality in HF patients with preserved LVEF. However, PP was not useful as a prognostic marker of mortality in acute HF. Further studies are needed to assess the relationship of this variable with mortality in HF patients.
Identifiants
pubmed: 36934810
pii: S2254-8874(23)00040-1
doi: 10.1016/j.rceng.2023.01.006
pii:
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
231-239Informations de copyright
Copyright © 2023. Published by Elsevier España, S.L.U.