Pulse pressure in acute heart failure: Insights from the hearts registry

Abstract

Introduction: Low Pulse Pressure (PP) predicts mortality in chronic symptomatic Heart Failure (HF). Data in Acute HF (AHF) are lacking. Our aim was to examine the prognostic value of PP in AHF for short- and long-term outcomes. Methodology: Data from the Heart Function Assessment Registry Trial (HEARTS) were analyzed. AHF patients were prospectively enrolled from October 2009 to December 2010, with a mortality follow-up until January 2013. Comparisons were done according to PP median value (50 mmHg). Primary outcomes were hospital adverse events and short and long-term mortality rates. Results: 2609 patients were included. In crude comparisons, patients with low PP had higher rates of recurrence of HF (35.4% vs. 26.5%; P < 0.001), and greater risk of hospital and 30-day mortality (7.8% vs. 5.1%; P 0.006 and 9.5% vs. 6.6%; P = 0.006, respectively). There were no differences observed in long-term mortality rates. Multiple regression analyses showed no independent role for PP on all studied outcomes. However, a subgroup analysis revealed that hospital mortality was greater in HF with reduced Ejection Fraction (HFrEF). Conclusion: Low PP was not predictive of mortality in the overall AHF population. However, it still remains an important prognostic marker in the HFrEF phenotype.