Document Detail


Noninvasively determined radial dP/dt is a predictor of mortality in patients with heart failure.
MedLine Citation:
PMID:  18371489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The left ventricular (LV) developed pressure is a marker of contractility, associated with a poor prognosis during systolic heart failure. The maximal first derivative or slope of the radial pulse wave (Rad dP/dt) has been proposed as a marker of LV systolic function. This study sought to assess the prognostic value of the baseline dP/dt of the radial pulse in patients with heart failure. METHODS: The Rad dP/dt was noninvasively measured by applanation tonometry, and its effect on mortality was analyzed by using multivariate Cox regression models. We studied 310 consecutive patients. Mean follow-up was 327 +/- 187 days, and 64 patients died or were transplanted during this period. RESULTS: Death or transplantation was associated with New York Heart Association class III or IV, low systolic or mean blood pressure, low LV ejection fraction, and low Rad dP/dt (634.6 +/- 373.3 vs 730.2 +/- 367.4 mm Hg/s for patients who survived without transplantation, P < .02). A Rad dP/dt <440 mm Hg/s was associated with death or transplantation before and after adjustment for confounding variables (OR [95% CI] 2.19 [1.33-3.58] and 2.88 [1.29-6.38], respectively, P < .01 for both). This relationship was independent of pulse pressure and no significant interaction was found between the Rad dP/dt and the pulse pressure. CONCLUSION: This study demonstrates, for the first time, that the Rad dP/dt, proposed as a noninvasive peripheral marker of LV systolic function, is an independent predictor of death or transplantation in patients with HF regardless of LV ejection fraction.
Authors:
Jean-Michel Tartière; Jean-Yves Tabet; Damien Logeart; Lamia Tartière-Kesri; Florence Beauvais; Christophe Chavelas; Alain Cohen Solal
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-21
Journal Detail:
Title:  American heart journal     Volume:  155     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-28     Completed Date:  2008-04-18     Revised Date:  2008-09-25    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-63     Citation Subset:  AIM; IM    
Affiliation:
Department of Physiology, Lariboisière Hospital, Assistance Publique, Paris, France. jean-michel.tartiere@lrb.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Follow-Up Studies
Heart Failure / mortality,  physiopathology*,  surgery
Heart Transplantation
Humans
Manometry
Multivariate Analysis
Prognosis
Proportional Hazards Models
Pulse
Radial Artery / physiology*
Stroke Volume
Ventricular Dysfunction, Left / diagnosis*,  physiopathology
Ventricular Function, Left
Ventricular Pressure
Comments/Corrections
Comment In:
Am Heart J. 2008 Sep;156(3):e21; author reply e23   [PMID:  18760110 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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