Abstract 14584: Differences in Pupillary Reflex Between Patients With Acute Heart Failure and Healthy Subjects. An Easy New Marker of Treatment Control in Heart Failure

Abstract

Introduction: In heart failure (HF), the sympathetic nervous system (SNS) is overactivated to try to maintain an adequate cardiac output. The pupillary reflex depends on the SNS and may be a new prognostic marker. Hypothesis: Pupillary reflex of patients with decompensated HF differs compared to controls, due to the hyperactivation of the SNS in acute HF. HF treatment may change pupillary reflex and may serve as a new marker of therapy. Aims: The aim was to compare the difference pupillary reflex between patients with acute HF and controls that may offer a new and easy prognostic factor in such patients. Methods: 107 pupillometry values of patients with decompensated HF were performed with NeuroOptics pupillometer prospectively and consecutively on admission and discharge, and compared with 42 pupillometry of controls. Results: HF patients have higher BMPD, higher MinPD and higher LC than controls.Patients with HF had higher BMPD and higher MinPD at admission vs. discharge (P<0.05). No significant differences were seen between HF patients at discharge and controls. It may be that pupillary reflex values reflect better disease control at discharge. Conclusions: Patients with decompensated HF have a higher BMPD and higher MinPD. Also, HF patients presented an improvement in pupillometric values at discharge and showed no differences compared to controls.This supports the hypothesis that patients with decompensated HF present a hyperactivation of the SNS that promotes mydriasis versus miosis. SNS activity is difficult to evaluate; the pupillary reflex can be a simple and useful tool to determine its status, establish prognostic, and could help to control therapeutic management.