title: Prognostic value of systolic short-term blood pressure variability in systolic heart failure.
abstract: BACKGROUND
  Traditional cardiovascular risk factors in the general population are usually correlated to a better prognosis in patients with chronic heart failure (HF). Most of the studies show that blood pressure variability (BPV) has noxious effect on general population but data are missing for patients with systolic HF. The aim of this study was to assess the prognostic impact of short-term blood pressure variability (BPV) in systolic HF.
  
  
  RESULTS
  We retrospectively studied 288 patients (60 ± 12 years-old; 79 % male) referred to our tertiary center of HF for the management of their systolic HF (left ventricular ejection fraction was 28 ± 9 %). All patients underwent ambulatory blood pressure monitoring (systolic BP: 110 ± 15; diastolic BP: 68 ± 10 and pulse pressure: 42 ± 11 mmHg) and the prognostic impact of BPV was collected with a mean follow-up of 4.4 ± 3.1 years. Twenty-five (9 %) patients were missing for follow-up. Among the others patients, 70 (27 %) cardiovascular events (cardiac deaths: 24 %; heart transplantation: 2 %) were recorded. By multivariate analysis BPV daytime (OR = 0.963, p = 0.033) and severe NYHA class (OR = 5.2, p < 0.0001) were found as independent predictors of cardiac event. Patients with a systolic daytime BPV under a cut-off value of 19 mmHg had the poorest prognosis with an OR for cumulative events of 1.65 (IC95 % 1.1-2.7; p < 0.04).
  
  
  CONCLUSIONS
  BPV is simple tool and a predictor of cardiac events in patients with systolic HF.
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France ; Rangueil Medical School, Toulouse, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Berry
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France ; Rangueil Medical School, Toulouse, France ; Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lairez
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Fourcade
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Purpan Medical School, Toulouse, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Roncalli
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France ; Purpan Medical School, Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Rangueil Medical School, Toulouse, France ; Department of Pharmacology, Purpan Medical School, Toulouse, France.
authors.forename: Atul
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Purpan Medical School, Toulouse, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Chamontin
authors.affiliation: Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France ; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France ; Rangueil Medical School, Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
keywords: Blood pressure variability; Heart failure; Prognosis