Proportional pulse pressure relates to cardiac index in stabilized acute heart failure patients

摘要

Aims: In chronic heart failure, proportional pulse pressure (PPP) is suggested as an estimate of cardiac index (Cl). The association between Cl and PPP in acute heart failure (AHF) has not been described. Methods: This was examined using hemodynamic measurements (from a trial using serelaxin) in 63 stabilized AHF patients. Results: Mean (SD) age was 68 (11), 74% male, mean (SD) ejection fraction (EF) was 33.4% (13.7), mean (SD) Cl (L/min/m2) was 2.3 (0.6). Cl correlated with PPP (Pearson R = 0.42;p < 0.0001) based on a linear mixed-effects model analysis of 171 pairs of measurements from 47 patients (out of 63) where Cl and PPP were measured within 3 min of each other during. Serelaxin treatment did not modify the established correlation between Cl and PPP. Time-weighted average Cl correlated with time-weighted average PPP (Spearman Rank R = 0.35; p = 0.0051) over the -4 h to 24 h time interval. In a multivariable regression analysis, low PPP was an independent predictor of low Cl (p < 0.0001). Conclusions: In patients with AHF after initial clinical stabilization, both baseline and post-baseline Cl measurements are positively related to PPP. This was the most closely related non-invasive blood pressure variable to Cl.