Noninvasively determined radial dP/dt is a predictor of mortality in patients with heart failure - 08/08/11
, Jean-Yves Tabet, MD b, Damien Logeart, MD, PhD b, Lamia Tartière-Kesri, MD b, Florence Beauvais, MD b, Christophe Chavelas, MD b, Alain Cohen Solal, MD, PhD bRésumé |
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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| This study was supported by a grant from the French Society of Cardiology. |
Vol 155 - N° 4
P. 758-763 - avril 2008 Retour au numéro
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