Abstract 9374: The Attenuation of Blood Pressure Lability Assessed by Frequency Analysis of Very Short-Term Continuous Blood Pressure Recording Reflects the Hemodynamic Aggravation in Heart Failure Patients with Reduced Ejection Fraction

Abstract

Introduction: The lower blood pressure variability (BPV) assessed by 24-hour ambulatory bloop pressure (BP) monitoring predicts cardiac events in heart failure with reduced ejection fraction (HFrEF) patients. However, the trends of BPV assessed by short-term continuous BP recording in HFrEF patients remains unknown. Hypothesis: We recently reported a novel method of BPV analysis which is focused on the power spectral density (PSD) of 30-min continuous BP recording. In the PSD, we defined the integrated area of PSD from 0.01Hz to 0.1Hz as an index of short-term BPV (BP lability index: BLI) (Figure 1). Since the worsening of cardiac function decreases the dynamic variability of BP, we hypothesized that reduced cardiac function lowers BLI. In this study, we investigated how the worsening of cardiac function alters BLI. Methods: We compared 33 HFrEF patients with 15 hypertensive (HT) patients as a normal cardiac function. We assessed baseline characteristics, the value of brain natriuretic peptide (BNP), echocardiography and 30-min continuous BP in those patients. BP time series in each subject was converted to PSD by the Fourier transform. Results: Compared to HT, HFrEF patients showed lower left ventricular ejection fraction (LVEF) (33.8±11.8 vs. 68.9±6.8 %, p<0.001) and higher E/e’ (17.5±10.8 vs. 10.5±2.7, p=0.002), indicating the hemodynamic aggravation. In continuous BP, HFrEF reduced both averaged systolic BP (122.0±18.1 vs. 137.9±19.7 mmHg, p=0.006) and pulse pressure (50.1±13.9 vs. 59.2±14.9 mmHg, p=0.037). BLI was significantly lower in HFrEF patients than that in HT (2.07±0.98 vs. 2.64±0.95, p=0.010]. Interestingly, the patients with reduced LVEF and high E/e’ showed lower BLI (Figure 2). Furthermore, BLI negatively associated with BNP (r=-0.38, p=0.012) (Figure 3). Conclusions: BLI was lower in HFrEF patients than that in HT patients with normal cardiac function. BLI has a potential to develop a novel marker of hemodynamic assessment in HFrEF patients.