Document Detail

Differential impact of heart rate and blood pressure on outcome in patients with heart failure with reduced versus preserved left ventricular ejection fraction.
MedLine Citation:
PMID:  21035207     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: In contrast to patients with heart failure (HF) with reduced left ventricular ejection fraction (LVEF; HFREF) the prognostic role of heart rate (HR) and blood pressure (BP) in patients with HF and preserved LVEF (HFPEF) is not well known. The aim of this study was to characterize the relationship between HR and BP and outcomes in HFPEF and to compare it to HFREF.
METHODS: The association between HR and BP and outcomes (median follow-up: 38months) was analyzed in patients with HFREF (LVEF≤45%; n=6792) and HFPEF (LVEF>45%; n=988) from the Digitalis Investigator Group trial.
RESULTS: Mortality (35% vs. 23%) and HF hospitalization rates (31% vs. 20%; p<0.001 for both) were higher in HFREF compared to HFPEF. In HFREF, higher HR and lower systolic and diastolic BP quartiles were associated with higher mortality and HF hospitalization rates. By contrast, there was no significant association between HR and BP respectively and mortality in HFPEF, and there was no significant association between systolic BP and hospitalization risk in HFPEF either. However, HF hospitalization rates were significantly related to increasing HR and decreasing diastolic BP quartile respectively (4.9, 6.8, 6.8, and 10.5 and 5.5, 8.1, 6.0, and 10.1 respectively events per 1000 person-years) in HFPEF. In HFPEF, there was also evidence of a significant J-shaped relationship between pulse pressure and mortality.
CONCLUSIONS: The prognostic value of HR and BP differed substantially between HFREF and HFPEF. These data may provide a foundation for the design of novel interventions in HFPEF patients.
Micha T Maeder; David M Kaye
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Publication Detail:
Type:  Journal Article     Date:  2010-10-28
Journal Detail:
Title:  International journal of cardiology     Volume:  155     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  249-56     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.
Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Heart Centre, Alfred Hospital, Melbourne, Australia; Cardiology Division, Kantonsspital St. Gallen, St. Gallen, Switzerland.
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