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Pulsatile Hemodynamics and Clinical Outcomes in Acute Heart Failure.
MedLine Citation:
PMID:  21372800     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 24 h 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.American Journal of Hypertension (2011). doi:10.1038/ajh.2011.26.
Authors:
Shih-Hsien Sung; Wen-Chung Yu; Hao-Min Cheng; Shao-Yuan Chuang; Kang-Ling Wang; Chi-Ming Huang; Chen-Huan Chen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-03
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1879-1905     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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