Utilidad pronóstica de la presión de pulso en pacientes con insuficiencia cardiaca con fracción de eyección preservada: Registro RICA

Abstract

Background and objectiveThe prognostic role of pulse pressure (PP) in patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) is not well understood. This study aimed to evaluate it in acute and stable HF. Material and methodsThis work is a retrospective observational study of patients included in the RICA registry between 2008 and 2021. Blood pressure was collected on admission (decompensation) and at three months (stability). PP was calculated and patients were categorized according to whether PP was greater than/equal to or less than 50mmHg. All-cause mortality at one year after admission was assessed. ResultsA total of 2,291 patients were included. The mean age was 80.1±7.7 years, 62.9% were women, and 16.7% had a history of ischemic heart disease. In the acute phase, there were no differences in mortality according to PP values, but in the stable phase, PP <50mmHg was independently associated with all-cause mortality at one year (HR 1.57, 95% CI 1.21-2.05, p=0.001) after adjusting for age, sex, New York Heart Association functional class, previous HF, chronic kidney disease, valvular heart disease, cerebrovascular disease, score on the Barthel and Pfeiffer scales, and hemoglobin and sodium levels. ConclusionsLow stable-phase PP was associated with increased all-cause mortality in HF patients with preserved LVEF. However, PP was not found to be a prognostic facture in the acute phase. Further studies are needed to assess the relationship of this variable with mortality in HF patients.