Abstract 11362: The Riser Pattern, a Novel Marker of Adverse Prognosis in Patients With Heart Failure With Preserved Ejection Fraction

Abstract

Introduction: The cardiovascular prognosis of heart failure with preserved ejection fraction (HFpEF) has been shown to be similar to that of heart failure with reduced ejection fraction (HFrEF). It is unknown which factors predict cardiovascular outcomes in HFpEF. Hypothesis: The abnormal pattern of circadian BP rhythm known as riser BP pattern is associated with adverse outcomes in HFpEF. Methods: We enrolled 516 hospitalized HF patients who underwent ambulatory BP monitoring (ABPM) (age, 69±13 yrs; 61% males [n=314] and 39% females [n=200]), and were followed up for 23±16 months. The combined endpoints consisted of all-cause mortality and cardiovascular events. Results: Combined endpoints were observed in 220 cases. In a Kaplan-Meier analysis, the riser BP pattern subgroup had a significantly higher incidence of combined endpoints than the other subgroups of the HFpEF patients (Figure). In a Cox regression analysis adjusted for significant variables, the riser BP pattern was a significant predictor of adverse outcomes in the HFpEF group (HR 3.01, 95%CI 1.54-6.08, p<0.01), but not in the HFrEF group. Conclusions: The riser BP pattern was found to be a novel predictor of cardiovascular outcomes in patients with HFpEF.