Abstract 18864: Pulsatile Hemodynamics and 6-month Outcomes in Patients Hospitalized due to Acute Heart Failure Syndrome
Background: The 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.
Methods and Results: A total of 80 AHFS patients (73.2±14.1 years, 82.5% men) were enrolled and followed for up to 6 months after discharge. Measures of the pulsatile hemodynamics including brachial and central systolic (SBP) and pulse (PP) pressure, carotid-femoral pulse wave velocity (cf-PWV), carotid augmentation index (cAI) and augmented pressure (cAP) were obtained at admission, before discharge, and 2 weeks after discharge. During a follow-up of 174±32 days (16 to 183 days), 29 patients experienced events including re-hospitalization for HF, non-fatal myocardial infarction, non-fatal stroke, and mortality. In the uneventful but not the eventful patients, progressive reduction of the pulsatile hemodynamics was observed. Pre-discharge brachial and central PP, and cAP, and post-discharge brachial and central SBP and PP, cAP, and cf-PWV were significantly lower in the uneventful patients. Pre-discharge central PP (HR per 1-SD and 95% CI: 1.592 [1.094–2.317]) and cAP [1.445 (1.030–2.029)] predicted events independent of age, sex, and NT-proBNP levels. Similarly, post-discharge brachial and central SBP and PP and cAP were also significant independent predictors.
Conclusions: In conclusion, pulsatile hemodynamics is important in the pathogenesis of AHFS, and suboptimal recovery of the perturbations of the pulsatile hemodynamics may relate to adverse outcomes and warrant more aggressive treatment.
- © 2010 by American Heart Association, Inc.