title: Initial emergency department systolic blood pressure predicts left ventricular systolic function in acute decompensated heart failure.
abstract: 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.
authors.affiliation: Department of Epidemiology and Biostatistics, Division of Health Services Research, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Styron
authors.forename: Preeti
authors.initials: P
authors.lastname: Jois-Bilowich
authors.forename: Randall
authors.initials: R
authors.lastname: Starling
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hobbs
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kontos
authors.forename: Peter S
authors.initials: PS
authors.lastname: Pang
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
mesh_terms: 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