NEW CONCEPT OF TRIGGER-SPECIFIC BLOOD PRESSURE SENSITIVITY “THERMOSENSITIVITY” MEASURED BY ICT-BASED MULTISENSOR ABPM IN PATIENTS WITH HEART FAILURE

Abstract

Objective: A sudden elevation of blood pressure (BP) by cold temperatures in winter is widely recognized as one of causes in exacerbation of heart failure. A reactivity of BP against changes in temperature in ambulatory setting remains unclear in patients with heart failure. We assessed the BP reactivity against changes of temperature using a newly developed device ICT-based Multisensor Ambulatory BP Monitoring (IMS-ABPM) in patients with heart failure. Design and method: The IMS-ABPM has accelerometer, thermometer and atmospheric barometer, which enable to measure physical activity, temperature and atmospheric pressure with measuring ambulatory BP. In this study, we evaluated trigger-specific BP sensitivity according to the ambulatory BP reactivity based on the slope of BP change against the triggers using the IMS-ABPM, which was “thermosensitivity” defined as the slope of BP change against temperature in the BP measurement. This study was a cross-sectional study to assess relationship between “thermosensitivity” and cardiac function by using IMS-ABPM in patients who had been admitted to a medical facility due to heart failure. Results: Among 103 patients with heart failure (mean ± SD age, 76.4 ± 14.4 years; 47.6% men), 55.6% of patients was heart failure with preserved ejection fraction (HFpEF). Although mean 24-hour systolic BP level and ambulatory BP variability evaluated coefficient of variation, average real variability had not significant difference between patients with HFpEF and heart failure with reduced ejection fraction (HFrEF), the thermosensitivity was significantly lower (hyperthermosensitive) in patients with HFpEF compared to HFrEF (HFpEF, –1.59 ± 3.22 vs. HFrEF, 0.08 ± 4.14, p = 0.038). After adjusted age and sex, the thermosensitivity was significantly associated with HFpEF. Moreover, the thermosensitivity tended to be correlated with ejection fraction in echocardiography (r = –0.21, p = 0.052 in Spearman's correlation). Conclusions: Based on the results of this study, patients with HFpEF showed lower thermosensitivity (hyperthermosensitive), which suggested BP strongly elevated with cold temperature, compared to patients with HFrEF. The new concept of trigger-specific BP sensitivity “thermosensitivity” might be associated with the exacerbation of heart failure in HFpEF.