Ha Jaehyung, Lee Chan Joo, Oh Jaewon, Park Sungha, Lee Sang-Hak, Kang Seok-Min
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Int J Heart Fail. 2023 Jun 19;5(3):150-158. doi: 10.36628/ijhf.2023.0004. eCollection 2023 Jul.
Compared to office blood pressure (OBP), central blood pressure (CBP) and ambulatory blood pressure (BP) are known to be better markers for predicting cardiovascular events. We evaluated the association between left ventricular reverse remodeling (LVRR) and ambulatory CBP in heart failure with reduced ejection fraction (HFrEF).
This study retrospectively analyzed 93 patients who performed ambulatory CBP and brachial BP (BBP) monitoring from 2018 to 2020 within 1 year after diagnosis of HFrEF at a single tertiary center. We analyzed the association between on-treatment ambulatory BPs and LVRR on follow-up echocardiography.
The mean age of participants was 59 years; 65.6% were men; mean LVEF was 29%. Ambulatory BP and follow-up echocardiography were done at 143 days (interquartile range [IQR], 64-267) and 454 days (IQR, 281-600) after diagnosis of HF, respectively. Baseline OBP was not different between 2 groups, but ambulatory systolic CBP was significantly higher in the LVRR group than the non-LVRR group (p=0.005). Systolic OBP (odds ratio [OR], 1.029; confidence interval [CI], 1.004-1.055; p=0.026), 24-hour ambulatory systolic CBP (OR, 1.048; CI, 1.015-1.082; p=0.004), and 24-hour ambulatory systolic BBP (OR, 1.049; CI,1.017-1.082; p=0.003) were associated with LVRR. Compared to ambulatory systolic CBP of 110-119 mmHg, 90-99 mmHg showed lower OR for LVRR.
Low on-treatment ambulatory systolic CBP was closely related to a lower likelihood of LVRR in HFrEF than the normal range. Ambulatory CBP measured during treatment of patients with HFrEF appears to be useful in predicting outcomes.
与诊室血压（OBP）相比，中心血压（CBP）和动态血压（BP）是预测心血管事件的更好指标。我们评估了射血分数降低的心力衰竭（HFrEF）患者左心室逆向重构（LVRR）与动态CBP之间的关联。
本研究回顾性分析了2018年至2020年在单一三级中心诊断为HFrEF后1年内进行动态CBP和肱动脉血压（BBP）监测的93例患者。我们分析了治疗期间的动态血压与随访超声心动图上LVRR之间的关联。
参与者的平均年龄为59岁；65.6%为男性；平均左心室射血分数（LVEF）为29%。动态血压和随访超声心动图分别在诊断心力衰竭后143天（四分位间距[IQR]，64 - 267）和454天（IQR，281 - 600）进行。两组之间的基线OBP无差异，但LVRR组的动态收缩期CBP显著高于非LVRR组（p = 0.005）。收缩期OBP（比值比[OR]，1.029；置信区间[CI]，1.004 - 1.055；p = 0.026）、24小时动态收缩期CBP（OR，1.048；CI，1.015 - 1.082；p = 0.004）和24小时动态收缩期BBP（OR，1.049；CI，1.017 - 1.082；p = 0.003）与LVRR相关。与动态收缩期CBP为110 - 119 mmHg相比，90 - 99 mmHg的LVRR的OR较低。
在HFrEF中，治疗期间低动态收缩期CBP与LVRR可能性较低密切相关，低于正常范围。在HFrEF患者治疗期间测量的动态CBP似乎有助于预测预后。
