Prognostic significance of post-exercise blood pressure response in patients with dilated cardiomyopathy.

BACKGROUND AND OBJECTIVES

The occurrence of an abnormal cardiovascular response during exercise in patients with chronic heart failure is well known. Post-exercise blood pressure response is also useful in assessing the severity of heart failure and impaired exercise capacity. This study evaluated the prognostic significance of post-exercise blood pressure response in patients with dilated cardiomyopathy.

METHODS

Thirty patients with dilated cardiomyopathy (left ventricular ejection fraction: 32 +/- 9%) were studied and the relationship between post-exercise blood pressure response and cardiac events (sudden death, heart failure death and readmission for heart failure) were evaluated. The post-exercise blood pressure response was defined as PBP3 (systolic blood pressure at 3 min after exercise divided by peak systolic blood pressure during exercise).

RESULTS

Seven cardiac events (one sudden death, two deaths for heart failure and four readmissions from heart failure) were observed during the follow-up period (3.3 +/- 1.8 years). The PBP3 in patients with these cardiac events was higher than that in patients without cardiac events (0.95 +/- 0.09 vs 0.84 +/- 0.10, p < 0.05). The area under the curve for the receiver-operating characteristic curve with PBP3 used to predict the cardiovascular events was 0.79 (95% confidence interval: 0.62-0.97, p = 0.02).

CONCLUSIONS

Post-exercise blood pressure response is a simple and useful predictor of adverse cardiac events in patients with dilated cardiomyopathy.