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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Prognostic value of systolic short-term blood pressure variability in systolic heart failure
Matthieu Berry1, Olivier Lairez2, Joelle Fourcade3
1Department 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.
Insights
Blood pressure variability (BPV) is a significant predictor of cardiac events in patients with systolic heart failure (HF). Higher BPV indicates a poorer prognosis, highlighting its clinical utility in managing HF patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Hypertension Research
Background:
- Traditional cardiovascular risk factors often correlate with better prognosis in heart failure (HF) patients.
- Blood pressure variability (BPV) is generally considered detrimental in the general population, but its prognostic impact in systolic HF is less understood.
Purpose of the Study:
- To investigate the prognostic significance of short-term blood pressure variability (BPV) in patients diagnosed with systolic heart failure.
Main Methods:
- Retrospective study of 288 systolic HF patients (mean age 60 years, 79% male) with LVEF of 28%.
- Ambulatory blood pressure monitoring was performed to assess BPV.
- A mean follow-up of 4.4 years was conducted to record cardiovascular events.
Main Results:
- Among 288 patients, 70 (27%) experienced cardiovascular events, including cardiac deaths (24%) and heart transplantation (2%).
- Daytime BPV (OR=0.963, p=0.033) and severe NYHA class (OR=5.2, p<0.0001) were independent predictors of cardiac events.
- Systolic daytime BPV below 19 mmHg was associated with the poorest prognosis (OR=1.65, p<0.04).
Conclusions:
- Blood pressure variability serves as a straightforward and valuable predictor of cardiac events in patients with systolic heart failure.
- Monitoring BPV can aid in risk stratification and management strategies for systolic HF patients.
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.
Methods And 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).
Conclusion:
BPV is simple tool and a predictor of cardiac events in patients with systolic HF.
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