Table 3. Prognostic value of measures of pulsatile hemodynamics in established HF.
| Study | First author | Setting/population | Sample size | Age | EF | Brachial SBP/DBP/PP mmHg | Relationship with outcome | |
|---|---|---|---|---|---|---|---|---|
| Brachial PP | ||||||||
| - | Fagard et al.99) | Advanced chronic HF | 284 | 51.5 | 25.5 | 114/75,739 | Inverse (all-cause mortality) | |
| PRIME | Voors et al.100) | Advanced chronic HF NYHA III and IV | 1,901 | 65 | 26 | 107/73 and 133/77; (above/below median PP) mean PP: 47 | Inverse (all-cause mortality) | |
| VMAC | Aronson and Burger101) | Hospitalized decompensated HF | 489 | 59/60/67 (PP Tertiles) | 21/26/34 (PP Tertiles) | 105/70/34; 119/68/51; 141/65/75 (PP tertiles) | Inverse (all-cause mortality) | |
| HIJC-HF | Kawashiro et al.102) | Hospitalized congestive HF | 3,169 | 69.8 | 42 | NA | Inverse (all-cause mortality increased with PP ≤30 mmHg) | |
| MAGGIC meta-analysis | Jackson et al.103) | HFrEF | 22,038 | 60–69 (PP quintiles) | 27–34 (PP quintiles) | 106–156/75–79 (PP quintiles) mean PP: 52 | Inverse (all-cause mortality) consistent findings in acute and chronic HFrEF | |
| - | Yildiran et al.104) | HF NYHA I–IV | 225 | 56.5 | 25–35 | 98–127/66–83/31–46 | Inverse (CV death) | |
| CAPRICORN | Petrie et al.105) | LV dysfunction (EF ≤40) after acute MI | 1,995 | 63 | 33 | 121/74/47 | Inverse (all-cause mortality) | |
| DIG | Maeder and Kaye106) | Stable HF | 6,792 (HFrEF) | 63 | 29 | 126/75/51 | Inverse (all-cause mortality) | |
| EPHESUS | Regnault et al.107) | 3–14 days after acute MI with LF dysfunction (EF ≤40) and HF | 6,613 | 64 | 33 | 119/72/47 | Inverse (all-cause mortality, CV death, CV death + hosp) | |
| - | Schillaci et al.108) | Outpatients with congestive HF | 8,660 | 64 | <30: 20% | 132/79/53 | Inverse (all-cause mortality, CV mortality) | |
| >30: 41% | ||||||||
| NA: 39% | ||||||||
| SAVE | Mitchell et al.109) | Impaired EF following MI (no overt HF) | 2,231 | 59.5 | 31 | 112–113/70/42–43 | Direct (all-cause mortality; recurrent MI) | |
| SOLVD | Domanski et al.110) | LV dysfunction (EF ≤35); asymptomatic or symptomatic (NYHA 1.7) | 6,781 | 55–64 | 26–28 | 109–144/77–78/32–67 | Direct (all-cause mortality, CV mortality) | |
| DCH cohort | Lip et al.111) | Incident HF | 2,159 | 58.9 | NA | 149/86.5/62.6 | Non-significant direct (stroke) | |
| GWTG-HF | Laskey et al.112) | Hospitalized HFrEF (EF <40) | 40,421 | 80 | 35–53 (PP quartiles) | 139/73 | U-shaped (inverse at PP <50 mmHg, direct at PP ≥50 mmHg) (all-cause mortality) | |
| GWTG-HF | Laskey et al.112) | Hospitalized HFpEF (EF ≥40) | Direct (all cause mortality) | |||||
| DIG | Maeder and Kaye106) | Stable HF | 988 (HFpEF) | 67 | 55 | 138/77/61 | J-shaped (all-cause mortality; HF hospitalization) | |
| MAGGIC metaanalysis | Jackson et al.103) | HFpEF | 5,008 | 65–73 (PP quintiles) | 58–60 (PP quintiles) | 115–172/77–80 (PP quintiles) mean PP: 62 | Direct (only unadjusted analysis) | |
| Inverse (subgroup with acute HFpEF) | ||||||||
| - | Tokitsu et al.116) | Hospitalized HFpEF | 512 | 71.7 | 63 | 134/73/61 | U-shaped (total CV events, HF events) | |
| Wave reflections | ||||||||
| - | Sung et al.113) | Acute heart failure NYHA III and IV | 120 | 72 | 41.2/42.9 | 141/81/60; 149/80/69 | Direct (cPP, Pb, AP) (HF hospitalization, MI, stroke, death); consistent effect in HFrEF and HFpEF | |
| Pulse wave velocity | ||||||||
| EPHESUS | Regnault et al.107) | 3–14 days after acute MI with LF dysfunction (EF ≤40) and HF | 306 | 61 | 34 | 118/74/89 | Direct (cfPWV) (all-cause mortality, CV mortality) | |
| - | Bonapace et al.115) | HF and EF ≤45% | 156 | Direct (aortic PWV) | ||||
| - | Meguro et al.114) | Stable HF NYHA II–III | 72 | 68 | 53 | 129/75/54 | Direct (baPWV) (HF hospitalisation, cardiac death) | |
AP = augmented pressure; baPWV = brachial-ankle pulse wave velocity; CAPRICORN = Carvedilol Post-Infarct Survival Control in LV Dysfunction; cfPWV = carotid-femoral pulse wave velocity; cPP = central pulse pressure; DBP = diastolic blood pressure; DCH = Diet, Cancer and Health; DIG = Digitalis Investigator Group; EF = ejection fraction; EPHESUS = Eplerenone Post–Acute Myocardial Infarction Heart Failure Efficacy and Survival Study; GWTG-HF = Get With The Guidelines-Heart Failure; other abbreviations see Tables 1,2 HIJC-HF = Heart Institute of Japan–Department of Cardiology Heart Failure; LV = left ventricle; MAGGIC = Meta-Analysis Global Group in Chronic Heart Failure; MI = myocardial infarction; Pb = amplitude backward wave; PP = pulse pressure; PRIME = Prospective Randomized study of Ibopamine on Mortality and Efficacy; SAVE = Survival and Ventricular Enlargement; SBP = systolic blood pressure; SOLVD = Studies on Left Ventricular Dysfunction; VMAC = Vasodilation in the Management of Acute Congestive HF.