Low Systolic Blood Pressure at Admission Predicts Long-Term Mortality in Heart Failure With Preserved Ejection Fraction

Buiciuc, Otilia; Ruşinaru, Dan; Lévy, F.; Peltier, Marcel; Slama, Michel; Leborgne, Laurent; Tribouilloy, Christophe

doi:10.1016/j.cardfail.2011.08.002

Cited by 32 publications

(27 citation statements)

References 25 publications

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“…Blood pressure (SBP, diastolic blood pressure, and MAP) were substantially lower before, during, and after exercise in patients who experienced a major cardiac event compared with those who remained event free. These data attest to the broad relevance of hemodynamics in HF management [18][19][20] and to the particular benefit of combining hemodynamics with ventilatory efficiency.…”

Section: Discussionmentioning

confidence: 57%

Ventilatory Power

Forman

Guazzi

Myers

et al. 2012

Circ: Heart Failure

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Background-Minute ventilation/CO 2 production (VE/Vco 2 ) slope is an index determined by cardiopulmonary exercise testing, which incorporates pertinent cardiac, pulmonary, and skeletal muscle physiology into a substantive composite assessment. The VE/Vco 2 slope has many applications, including utility as a well-validated prognostic gauge for patients with heart failure (HF). In this study, we combine VE/Vco 2 slope with systolic blood pressure, creating a novel index that we labeled ventilatory power. Ventilatory power links the combined physiology inherent in the VE/Vco 2 slope to peripheral pressure, adding an additional dimension pertinent to HF assessment. Whereas the related concept of circulatory power links peak oxygen consumption with peak systolic blood pressure as a prognostic index, we hypothesized that ventilatory power would provide greater prognostic discrimination than VE/Vco 2 slope, peak oxygen consumption, and circulatory power for patients with systolic HF. Methods and Results-Patients with systolic HF (left ventricular ejection fraction ≤35%) underwent symptom-limited cardiopulmonary exercise testing as part of routine management and were followed for up to 4 years for major cardiac events (mortality, left ventricular assist device implantation, and heart transplantation). Eight hundred seventy-five patients with HF (left ventricular ejection fraction, 26±9%; mean age, 55±14) were studied. Cardiopulmonary exercise testing indices peak oxygen consumption, VE/Vco 2 slope, circulatory power, and ventilatory power were all predictive of cardiac events (P<0.001). Multivariate analysis demonstrated that ventilatory power was the strongest indicator of prognosis. Conclusions-Although circulatory power and traditional cardiopulmonary exercise testing parameters can be used to predict prognosis among patients with HF, ventilatory power provides relatively greater prognostic discrimination and may constitute a relatively more useful composite tool. (Circ Heart Fail. 2012;5:621-626.)

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Section: Discussionmentioning

confidence: 57%

Ventilatory Power

Forman

Guazzi

Myers

et al. 2012

Circ: Heart Failure

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“…Over the last few years, a significant body of literature has accumulated examining the various clinical and biochemical variables in HFpEF patients ( Table 2) [50][51][52][53][54][55]. Whether HFpEF results in a similar or lower mortality than HFrEF is still unclear.…”

Section: Association Between the Clinical Variables And Outcome In Hementioning

confidence: 99%

Heart failure with preserved ejection fraction

Liu

Haddad²,

Dwivedi³

2013

Current Opinion in Cardiology

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“…En este sentido, los primeros estudios se realizaron en pacientes con FEVI reducida 11 . Sin embargo, en nuestro estudio, con una alta proporción de pacientes con FEVI preservada, la asociación se mantiene, algo que han encontrado también otros autores 12 . Nuestros resultados proceden de una muestra limitada de pacientes, por lo que es difícil extraer conclusiones más allá de la mera descripción, más aún acerca de la posible causalidad de la relación.…”

Section: Discussionunclassified

“…También se ha debatido si es mejor marcador pronóstico la PAS, PAD o PA media (PAM) 2 , en nuestro estudio encontramos claramente una asociación con la PAS, coincidiendo con otros estudios previos 12,13 .…”

Section: Discussionunclassified