| Noninvasively determined radial dP/dt is a predictor of mortality in patients with heart failure. | |
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MedLine Citation:
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PMID: 18371489 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jean-Michel Tartière; Jean-Yves Tabet; Damien Logeart; Lamia Tartière-Kesri; Florence Beauvais; Christophe Chavelas; Alain Cohen Solal |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-02-21 |
Journal Detail:
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Title: American heart journal Volume: 155 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-28 Completed Date: 2008-04-18 Revised Date: 2008-09-25 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 758-63 Citation Subset: AIM; IM |
Affiliation:
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Department of Physiology, Lariboisière Hospital, Assistance Publique, Paris, France. jean-michel.tartiere@lrb.aphp.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Am Heart J. 2008 Sep;156(3):e21; author reply e23
[PMID:
18760110
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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