Ambulatory blood pressure monitoring of patients with heart failure. A new prognosis marker.
OBJECTIVE
To evaluate the relationship between 24-hour ambulatory arterial blood pressure monitoring and the prognosis of patients with advanced congestive heart failure.


METHODS
We studied 38 patients with NYHA functional class IV congestive heart failure, and analyzed left ventricular ejection fraction, diastolic diameter, and ambulatory blood pressure monitoring data.


RESULTS
Twelve deaths occurred. Left ventricular ejection fraction (35.2 +/-7.3%) and diastolic diameter (72.2 +/- 7.8mm) were not correlated with the survival. The mean 24-hour (SBP24), waking (SBPw), and sleeping (SBPs) systolic pressures of the living patients were higher than those of the deceased patients and were significant for predicting survival. Patients with mean SBP24, SBPv, and SBPs >/=105mmHg had longer survival (p=0.002, p=0.01 and p=0.0007, respectively). Patients with diastolic blood pressure sleep decrements (dip) and patients with mean blood pressure dip </= 6mmHg had longer survival (p=0.04 and p=0.01, respectively). In the multivariate analysis, SBPs was the only variable with an odds ratio of 7.61 (CI: 1.56; 3704) (p=0.01). Patients with mean SBP<105mmHg were 7.6 times more likely to die than those with SBP >/= 105 mmHg


CONCLUSIONS
Ambulatory blood pressure monitoring appears to be a useful method for evaluating patients with congestive heart failure.
Canesin
Manoel F
MF
Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina, Londrina, PR, Brazil. mcanesin@cardiol.br
Giorgi
Dante
D
Oliveira
Múcio T de
MT
Wajngarten
Maurício
M
Mansur
Alfredo J
AJ
Ramires
José Antonio F
JA
Barretto
Antonio Carlos Pereira
AC
D000328:Adult; D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016138:Walking / Q000502:physiology