title: Low pulse pressure as a poor-man's indicator of a low cardiac index in patients with severe cardiac dysfunction.
abstract: OBJECTIVE
  A low pulse pressure (PP) may reflect poor cardiac output (CO), but has not been well characterized by invasive haemodynamic studies.
  
  
  METHODS
  We investigated the relationship between PP and cardiac index (CI) in patients with cardiovascular disease including those with normal and impaired cardiac function. Cardiac catheterization data from 1897 patients was analysed.
  
  
  RESULTS
  Mean age was 59 years; 57% were men, mean (SD) PP was 65 (25) mmHg and mean (SD) CI was 2.9 (0.8) l/min/m. Correlation between CI and PP was absent if the CI was more than 3 l/min/m, with a weak correlation if CI was between 2 and 3 l/min/m (r = 0.161; P < 0.001). For those with a CI of less than 2 l/min/m, the correlation was much stronger (r = 0.414; P < 0.001). In a multivariable regression analysis, a low PP predicted a low CI, at cardiac indices of less than 3 l/min/m. This was independent of potential confounders, including age, sex, presence of hypertension, presence of heart failure, presence of aortic stenosis, diabetes, renal function, heart rate, systemic vascular resistance, left ventricular end diastolic pressure and mean arterial pressure.
  
  
  CONCLUSIONS
  In patients with a CI of less than 3 l/min/m, a low PP is a marker of a low CI. In patients with severe heart failure and a low CO, PP pressure might be useful as a 'poor-man's' surrogate of CO.
authors.affiliation: aDepartment of Cardiology, Monklands Hospital, Monkscourt Avenue Airdrie, Glasgow, Scotland, UK bDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands cBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: Petrie
authors.forename: Kevin
authors.initials: K
authors.lastname: Damman
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Van Veldhuisen
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization / Q000379:methods; D002302:Cardiac Output / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results