title: Low systolic blood pressure on admission predicts mortality in patients with acute decompensated heart failure due to moderate to severe aortic stenosis.
abstract: BACKGROUND
  We investigated the relationship between admission systolic blood pressure (SBP) and all-cause mortality in patients hospitalized for acute decompensated heart failure (ADHF) because of aortic stenosis (AS).
  
  
  RESULTS
  We retrospectively reviewed the data for 71 consecutive patients (mean age 85±7 years) who had been hospitalized for ADHF because of AS between January 2006 and August 2012. The primary endpoint of the study was the 1-year all-cause mortality. Clinical outcomes of patients who survived and those who died during a 1-year period were compared. Low admission SBP was defined as <120 mmHg. During the 1-year period, 26 (37%) of the 71 patients died, including 16 (57%) of 28 patients with low SBP and 10 (23%) of 43 patients with normal or high SBP (log-rank P=0.0065). In both the patients who survived and those who died, there were significant differences in admission SBP (152±43 vs. 116±32 mmHg, P<0.001), estimated glomerular filtration rate on admission (43.2±20.3 vs. 28.2±22.2 ml·min(-1)·1.73 m(-2), P=0.005), and left ventricular ejection fraction <50% (33% [15/45] vs. 65% [17/26], P=0.013). Low admission SBP independently predicted 1-year all-cause mortality (adjusted hazard ratio: 2.41, 95% confidence interval: 1.04-5.57, P=0.033).
  
  
  CONCLUSIONS
  Low admission SBP is associated with significantly higher 1-year all-cause mortality in patients hospitalized for ADHF because of AS.
authors.affiliation: Department of Cardiovascular Medicine, Kurashiki Central Hospital.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawase
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.forename: Michitaka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Reo
authors.initials: R
authors.lastname: Hata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyawaki
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kubo
authors.forename: Seiji
authors.initials: S
authors.lastname: Habara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Maruo
authors.forename: Harumi
authors.initials: H
authors.lastname: Katoh
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D001794:Blood Pressure; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013318:Stroke Volume; D015996:Survival Rate