First Department of Cardiology, Medical University of Gdansk, Poland.
Cardiol J. 2019;26(1):20-28. doi: 10.5603/CJ.a2017.0130. Epub 2017 Nov 13.
Chronic heart failure (CHF) is an important epidemiological and therapeuthic issue with poor prognosis. The aim of the study was to estimate the prognostic value of daytime heart rate (HR), blood pressure (BP), their products and quotients in patients with CHF.
The study included 80 stable patients with CHF and reduced left ventricular ejection frac- tion (LVEF ≤ 35%). Physical examination, laboratory blood tests, electrocardiogram, chest X-ray, echocardiography, 6-minute walk test, telemetry monitoring and BP measurements were performed in all participants. We estimated mean daytime: BP, HR, their products and quotients. The follow-up period was 6 months. Major adverse cardiac events (MACE) included: death, cardiovascular death, hospitalization due to CHF exacerbation.
The analysis involved all recruited patients with CHF (91% men) aged 59 ± 12 years, in New York Heart Association class 2.15 ± 0.57 and reduced LVEF (mean LVEF: 23 ± 6%). The 3-month and 6-month mortality rates were 4% and 6%, respectively. There was a significant correlation between diastolic blood pressure (DBP), all-cause mortality (p = 0.048) and CHF decompensation (p = 0.0004) after 3-month observation period. No relationship was found between HR or systolic blood pressure (SBP) and MACE. Both higher SBP × HR and DBP × HR products were related to lower risk of heart failure exacerbations during 6-month follow-up. None of the analyzed products or ratios had an impact on mortality in this study group.
Diastolic blood pressure, SBP × HR and DBP × HR products may be useful in sub- sequent heart failure exacerbation risk stratification. Moreover, DBP value may predict short-term mortality in patients with CHF.
慢性心力衰竭（CHF）是一个具有预后不良的重要的流行病学和治疗学问题。本研究旨在评估心率（HR）、血压（BP）及其乘积和商在心力衰竭患者中的预后价值。
本研究纳入了 80 例稳定的射血分数降低的心力衰竭（LVEF ≤ 35%）患者。所有参与者均进行体格检查、实验室血液检查、心电图、胸部 X 线、超声心动图、6 分钟步行试验、遥测监测和血压测量。我们评估了白天的平均 HR、BP、其乘积和商。随访时间为 6 个月。主要不良心脏事件（MACE）包括死亡、心血管死亡、心力衰竭恶化住院。
分析涉及所有招募的心力衰竭患者（91%为男性），年龄 59 ± 12 岁，纽约心脏协会（NYHA）心功能分级为 2.15 ± 0.57，LVEF 降低（平均 LVEF：23 ± 6%）。3 个月和 6 个月的死亡率分别为 4%和 6%。在 3 个月的观察期后，舒张压（DBP）与全因死亡率（p = 0.048）和心力衰竭失代偿（p = 0.0004）呈显著相关。心率（HR）或收缩压（SBP）与 MACE 之间未发现相关性。SBP×HR 和 DBP×HR 的乘积越高，心力衰竭恶化的风险越低。在本研究组中，分析的产品或比值均未对死亡率产生影响。
舒张压、SBP×HR 和 DBP×HR 的乘积可能有助于心力衰竭恶化风险的分层。此外，DBP 值可能预测心力衰竭患者的短期死亡率。
