Abstract 12979: Pulse Pressure Variation Predicts Mortality After Acute Myocardial Infarction
Increased pulse pressure (PP) is associated with increased risk of cardiovascular events, however, little is known about PP beat-to-beat variation. Aim of this study was to assess PP variation and its association with mortality in post-infarction patients.
Methods: Prospective inclusion of 938 consecutive post-infarction patients in sinus rhythm aged <=80 years. Non-invasive 30-min recordings of arterial pressure (Portapres) 7 ± 2 days after index infarction. Quantification of PP variation by PP standard deviation (PPSD), and PP phase rectification (PPPR) assessed by modified phase-rectified signal averaging. Figure shows PPPR examples. Follow-up period was 5 years. Primary endpoint was total mortality.
Results: During follow-up, 61 patients (6.5%) died. Mortality was strongly correlated with PPPR (p<0.0001) and moderately correlated with PPSD (p<0.05) .High values of PPSD and PPPR indicated increased mortality risk. In multivariable Cox regression adjusted for known risk predictors (age, history of a previous infarction, diabetes mellitus, LVEF, mean heart rate, heart rate turbulence and deceleration capacity), PPPR was significantly associated with mortality (p=0.001).
Conclusions: Increased beat-to-beat pulse pressure variation is a strong and independent predictor of mortality after myocardial infarction.
- © 2010 by American Heart Association, Inc.