Pulsatile hemodynamics and clinical outcomes in acute heart failure

Shih Hsien Sung, Wen Chung Yu, Hao Min Cheng, Shao Yuan Chuang, Kang Ling Wang, Chi Ming Huang, Chen Huan Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

BackgroundThe role of pulsatile hemodynamics in the management of patients with acute heart failure syndrome (AHFS) remains to be elucidated. We investigated the changes of the pulsatile hemodynamics along the hospital course of AHFS in relation to short-term outcomes.MethodsA total of 80 AHFS patients (73.2 14.1 years, 82.5% men) were enrolled and followed up for up to 6 months after discharge. Measures of the pulsatile hemodynamics including brachial and central systolic blood pressure (SBP) and pulse (PP) pressure, carotid-femoral pulse wave velocity (cf-PWV), carotid augmentation index (cAI and cAI 75) and carotid augmented pressure (cAP) were obtained within 24h of admission, before discharge, and 2 weeks after discharge.ResultsDuring a follow-up of 174 32 days (16-183 days), 29 patients experienced events including rehospitalization for heart failure, nonfatal myocardial infarction, nonfatal stroke, and mortality. Predischarge brachial and central PP, and cAP, and postdischarge brachial and central SBP and PP, cAP, and cf-PWV were significantly lower in patients without events than those with events. Predischarge central PP (hazard ratio per 1-s.d. and 95% confidence interval 1.62 (1.12-2.34)) and cAP (1.47 (1.05-2.05)) predicted events independent of age and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Similarly, postdischarge brachial and central SBP and PP, cAP, and cf-PWV were also significant independent predictors. ConclusionSuboptimal recovery of the perturbations of the pulsatile hemodynamics in patients hospitalized due to AHFS may relate to adverse short-term outcomes and warrant aggressive treatment.

Original languageEnglish
Pages (from-to)775-782
Number of pages8
JournalAmerican Journal of Hypertension
Volume24
Issue number7
DOIs
StatePublished - Jul 2011

Keywords

  • acute heart failure syndrome
  • blood pressure
  • central blood pressure
  • hypertension
  • pulsatile hemodynamics

Fingerprint

Dive into the research topics of 'Pulsatile hemodynamics and clinical outcomes in acute heart failure'. Together they form a unique fingerprint.

Cite this