Styron Joseph F, Jois-Bilowich Preeti, Starling Randall, Hobbs Robert E, Kontos Michael C, Pang Peter S, Peacock W Frank
Department of Epidemiology and Biostatistics, Division of Health Services Research, Case Western Reserve University, Cleveland, OH, USA.
Congest Heart Fail. 2009 Jan-Feb;15(1):9-13. doi: 10.1111/j.1751-7133.2008.00047.x.
Ejection fraction (EF) is often unknown in patients who present with acute decompensated heart failure (ADHF). The objective of this study was to determine whether a patient's systolic blood pressure is associated with their left ventricular EF. This study was a retrospective chart review of all patients admitted to an emergency department (ED) observation unit from January 2002 to December 2004. A low EF was defined as <40%. Among 475 patients, the median age was 72 years, 53% were men, 40% were white, 59% were black, and 59% had a low EF. Patients with low EFs were more likely male ( P<.0001), with prior congestive heart disease ( P<.0001), longer QRS duration ( P<.0001), left bundle branch block ( P<.0001), and higher B-type natriuretic peptide ( P<.0001). The low EF group was less likely to have diabetes ( P<.0001). Adjusted odds ratios for an EF >or=40% were significant at all systolic blood pressure readings >120 mm Hg. Having an ED systolic BP >120 mm Hg is associated with significantly higher rates of preserved left ventricular systolic function in patients with ADHF.
