Non-invasive pulse wave analysis in patients with acute decompensation of chronic systolic heart failure.

Česká verzia

Authors: O. Ludka
Authors place of work: ICRC Brno ; Interní kardiologická klinika FN Brno a LF MU, Brno
Published in the journal: Kardiol Rev Int Med 2011, 13(4): 241-248

Summary

Introduction:
In recent years an increasing number of evidence that the pathophysiology of heart failure, arterial wall stiffness applied. Increased pulse pressure is associated with increased cardiovascular morbidity and mortality in patients with asymptomatic left ventricular dysfunction and also in patients with mild heart failure. Conversely, decreased pulse pressure according to some work associated with increased mortality in patients with acute decompensation of chronic heart failure in patients with advanced heart failure and is also associated with elevated B-type natriuretic peptide (BNP).

Aim:
To determine the value of pulse pressure and other parameters of pulse waves through the non-invasive analysis of patients hospitalized for acute decompensation of chronic systolic heart failure.

Methods:
A prospective monocentric study with a focus on non-invasive pulse wave analysis using an apparatus SphygmoCor. Patients: 130 patients, 77% men, 23% women, age 70 years, body mass index 28.4 kg/m², the etiology of chronic heart failure – 65.9% of ischemic heart disease, dilated cardiomyopathy 29.5%, 4.6% other , long-term NYHA I/II/III – 17/41.9/41.1%, on admission – oedema of the lower extremities 58.9%, rales in the lungs 88.3%, orthopnea 53.1%, BNP at admission 1765,7 pg/ml, at dicharge 962.3 pg/ml, left ventricular ejection fraction 27.5%, length of hospital stay 9 days.

Results:
(median, 5 percentile, 95 percentile), pulse pressure 32, 18, 59 mmHg, augmentation pressure 6, 0, 19 mmHg, augmentation index 17, 2, 37.

Conclusion:
Patients hospitalized for acute decompensation of chronic systolic heart failure have after stabilization lower value of pulse pressure, augmentation index, augmentation pressure compared to reference values.

Keywords:
chronic heart failure – non-invasive pulse wave analysis – pulse pressure – augmentation pressure – augmentation index

Supported by grant Ministry of Health Czech Republic 10422-3/2009.

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