Initial emergency department systolic blood pressure predicts left ventricular systolic function in acute decompensated heart failure.
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.
Styron
Joseph F
JF
Department of Epidemiology and Biostatistics, Division of Health Services Research, Case Western Reserve University, Cleveland, OH, USA.
Jois-Bilowich
Preeti
P
Starling
Randall
R
Hobbs
Robert E
RE
Kontos
Michael C
MC
Pang
Peter S
PS
Peacock
W Frank
WF
D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D016001:Confidence Intervals; D004636:Emergency Service, Hospital; D005260:Female; D006305:Health Status Indicators; D054143:Heart Failure, Systolic / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D016277:Ventricular Function, Left