Excess Pressure Integral Predicts Long-Term All-Cause Mortality in Stable Heart Failure Patients
Excess pressure integral (XSPI) derived from reservoir-excess pressure analysis is proposed as a novel indicator of cardiovascular dysfunction in hypertensives. Our study investigated the prognostic value of XSPI for stable heart failure (HF) patients. In total, 238 subjects (mean age 63 ± 18 years,...
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Veröffentlicht in: | American journal of hypertension 2017-03, Vol.30 (3), p.271-278 |
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description | Excess pressure integral (XSPI) derived from reservoir-excess pressure analysis is proposed as a novel indicator of cardiovascular dysfunction in hypertensives. Our study investigated the prognostic value of XSPI for stable heart failure (HF) patients.
In total, 238 subjects (mean age 63 ± 18 years, 111 male), comprising 168 stable HF patients with either reduced (SHF; n = 64) left ventricular (LV) ejection fraction (EF) or isolated diastolic dysfunction (DHF, n = 104), and 70 healthy controls, were enrolled. Tonometry-derived carotid pressure waveforms were analyzed with the reservoir pressure theory. XSPI was calculated by subtracting the reservoir pressure from carotid pressure waveform.
XSPI in SHF and DHF (14.01 ± 5.16 and 13.90 ± 5.05 mm Hg•s) were significantly higher than that in controls (11.01 ± 3.67 mm Hg•s, both P < 0.001). During a median follow-up of 9.9 years, 56 deaths occurred. XSPI was a significant independent predictor of total mortality after adjusting for age, sex, left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio = 4.37 per 1 SD, 95% confidence interval, 1.31-14.58). In subgroup analysis by different baseline characteristics including age, gender, NT-proBNP, LVEF, and GFR, higher XSPI was consistently associated with greater risk of total mortality.
In patients with stable HF, XSPI, a novel maker of cardiovascular dysfunction, was associated with long-term risk of total mortality. |
doi_str_mv | 10.1093/ajh/hpw133 |
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In total, 238 subjects (mean age 63 ± 18 years, 111 male), comprising 168 stable HF patients with either reduced (SHF; n = 64) left ventricular (LV) ejection fraction (EF) or isolated diastolic dysfunction (DHF, n = 104), and 70 healthy controls, were enrolled. Tonometry-derived carotid pressure waveforms were analyzed with the reservoir pressure theory. XSPI was calculated by subtracting the reservoir pressure from carotid pressure waveform.
XSPI in SHF and DHF (14.01 ± 5.16 and 13.90 ± 5.05 mm Hg•s) were significantly higher than that in controls (11.01 ± 3.67 mm Hg•s, both P < 0.001). During a median follow-up of 9.9 years, 56 deaths occurred. XSPI was a significant independent predictor of total mortality after adjusting for age, sex, left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio = 4.37 per 1 SD, 95% confidence interval, 1.31-14.58). In subgroup analysis by different baseline characteristics including age, gender, NT-proBNP, LVEF, and GFR, higher XSPI was consistently associated with greater risk of total mortality.
In patients with stable HF, XSPI, a novel maker of cardiovascular dysfunction, was associated with long-term risk of total mortality.</description><identifier>ISSN: 0895-7061</identifier><identifier>EISSN: 1941-7225</identifier><identifier>DOI: 10.1093/ajh/hpw133</identifier><identifier>PMID: 27838626</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Blood Pressure ; Carotid Arteries - physiopathology ; Female ; Heart Failure - mortality ; Humans ; Hypertension - mortality ; Male ; Manometry ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Sex Factors ; Stroke Volume ; Taiwan - epidemiology ; Wavelet Analysis</subject><ispartof>American journal of hypertension, 2017-03, Vol.30 (3), p.271-278</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c323t-a189eaf968a4c75b18d6ba31d14101320e0505a6060abb0b273775f42c07636b3</citedby><cites>FETCH-LOGICAL-c323t-a189eaf968a4c75b18d6ba31d14101320e0505a6060abb0b273775f42c07636b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27838626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Wei-Ting</creatorcontrib><creatorcontrib>Sung, Shih-Hsien</creatorcontrib><creatorcontrib>Wang, Jiun-Jr</creatorcontrib><creatorcontrib>Wu, Cho-Kai</creatorcontrib><creatorcontrib>Lin, Lian-Yu</creatorcontrib><creatorcontrib>Lee, Jia-Chun</creatorcontrib><creatorcontrib>Cheng, Hao-Min</creatorcontrib><creatorcontrib>Chen, Chen-Huan</creatorcontrib><title>Excess Pressure Integral Predicts Long-Term All-Cause Mortality in Stable Heart Failure Patients</title><title>American journal of hypertension</title><addtitle>Am J Hypertens</addtitle><description>Excess pressure integral (XSPI) derived from reservoir-excess pressure analysis is proposed as a novel indicator of cardiovascular dysfunction in hypertensives. Our study investigated the prognostic value of XSPI for stable heart failure (HF) patients.
In total, 238 subjects (mean age 63 ± 18 years, 111 male), comprising 168 stable HF patients with either reduced (SHF; n = 64) left ventricular (LV) ejection fraction (EF) or isolated diastolic dysfunction (DHF, n = 104), and 70 healthy controls, were enrolled. Tonometry-derived carotid pressure waveforms were analyzed with the reservoir pressure theory. XSPI was calculated by subtracting the reservoir pressure from carotid pressure waveform.
XSPI in SHF and DHF (14.01 ± 5.16 and 13.90 ± 5.05 mm Hg•s) were significantly higher than that in controls (11.01 ± 3.67 mm Hg•s, both P < 0.001). During a median follow-up of 9.9 years, 56 deaths occurred. XSPI was a significant independent predictor of total mortality after adjusting for age, sex, left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio = 4.37 per 1 SD, 95% confidence interval, 1.31-14.58). In subgroup analysis by different baseline characteristics including age, gender, NT-proBNP, LVEF, and GFR, higher XSPI was consistently associated with greater risk of total mortality.
In patients with stable HF, XSPI, a novel maker of cardiovascular dysfunction, was associated with long-term risk of total mortality.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Pressure</subject><subject>Carotid Arteries - physiopathology</subject><subject>Female</subject><subject>Heart Failure - mortality</subject><subject>Humans</subject><subject>Hypertension - mortality</subject><subject>Male</subject><subject>Manometry</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Sex Factors</subject><subject>Stroke Volume</subject><subject>Taiwan - epidemiology</subject><subject>Wavelet Analysis</subject><issn>0895-7061</issn><issn>1941-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kM1OwkAURidGI4hufAAzS2NSmZ922i4JASHBSCKu6532FkqGFmemUd7eEtDN_ZKbk7M4hNxz9sxZKoew3Qw3-28u5QXp8zTkQSxEdEn6LEmjIGaK98iNc1vGWKgUvyY9EScyUUL1yefkJ0fn6NJ2t7VI57XHtQVz_BRV7h1dNPU6WKHd0ZExwRhah_S1sR5M5Q-0qum7B22QzhCsp1OozNGzBF9h7d0tuSrBOLw774B8TCer8SxYvL3Mx6NFkEshfQA8SRHKVCUQ5nGkeVIoDZIXPOSMS8GQRSwCxRQDrZkWsYzjqAxFzmIllZYD8njy7m3z1aLz2a5yORoDNTaty3giU94lEmmHPp3Q3DbOWSyzva12YA8ZZ9mxaNYVzU5FO_jh7G31Dot_9C-h_AXJZXGH</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Wang, Wei-Ting</creator><creator>Sung, Shih-Hsien</creator><creator>Wang, Jiun-Jr</creator><creator>Wu, Cho-Kai</creator><creator>Lin, Lian-Yu</creator><creator>Lee, Jia-Chun</creator><creator>Cheng, Hao-Min</creator><creator>Chen, Chen-Huan</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Excess Pressure Integral Predicts Long-Term All-Cause Mortality in Stable Heart Failure Patients</title><author>Wang, Wei-Ting ; Sung, Shih-Hsien ; Wang, Jiun-Jr ; Wu, Cho-Kai ; Lin, Lian-Yu ; Lee, Jia-Chun ; Cheng, Hao-Min ; Chen, Chen-Huan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c323t-a189eaf968a4c75b18d6ba31d14101320e0505a6060abb0b273775f42c07636b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Pressure</topic><topic>Carotid Arteries - physiopathology</topic><topic>Female</topic><topic>Heart Failure - mortality</topic><topic>Humans</topic><topic>Hypertension - mortality</topic><topic>Male</topic><topic>Manometry</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Sex Factors</topic><topic>Stroke Volume</topic><topic>Taiwan - epidemiology</topic><topic>Wavelet Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Wei-Ting</creatorcontrib><creatorcontrib>Sung, Shih-Hsien</creatorcontrib><creatorcontrib>Wang, Jiun-Jr</creatorcontrib><creatorcontrib>Wu, Cho-Kai</creatorcontrib><creatorcontrib>Lin, Lian-Yu</creatorcontrib><creatorcontrib>Lee, Jia-Chun</creatorcontrib><creatorcontrib>Cheng, Hao-Min</creatorcontrib><creatorcontrib>Chen, Chen-Huan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Wei-Ting</au><au>Sung, Shih-Hsien</au><au>Wang, Jiun-Jr</au><au>Wu, Cho-Kai</au><au>Lin, Lian-Yu</au><au>Lee, Jia-Chun</au><au>Cheng, Hao-Min</au><au>Chen, Chen-Huan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excess Pressure Integral Predicts Long-Term All-Cause Mortality in Stable Heart Failure Patients</atitle><jtitle>American journal of hypertension</jtitle><addtitle>Am J Hypertens</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>30</volume><issue>3</issue><spage>271</spage><epage>278</epage><pages>271-278</pages><issn>0895-7061</issn><eissn>1941-7225</eissn><abstract>Excess pressure integral (XSPI) derived from reservoir-excess pressure analysis is proposed as a novel indicator of cardiovascular dysfunction in hypertensives. Our study investigated the prognostic value of XSPI for stable heart failure (HF) patients.
In total, 238 subjects (mean age 63 ± 18 years, 111 male), comprising 168 stable HF patients with either reduced (SHF; n = 64) left ventricular (LV) ejection fraction (EF) or isolated diastolic dysfunction (DHF, n = 104), and 70 healthy controls, were enrolled. Tonometry-derived carotid pressure waveforms were analyzed with the reservoir pressure theory. XSPI was calculated by subtracting the reservoir pressure from carotid pressure waveform.
XSPI in SHF and DHF (14.01 ± 5.16 and 13.90 ± 5.05 mm Hg•s) were significantly higher than that in controls (11.01 ± 3.67 mm Hg•s, both P < 0.001). During a median follow-up of 9.9 years, 56 deaths occurred. XSPI was a significant independent predictor of total mortality after adjusting for age, sex, left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio = 4.37 per 1 SD, 95% confidence interval, 1.31-14.58). In subgroup analysis by different baseline characteristics including age, gender, NT-proBNP, LVEF, and GFR, higher XSPI was consistently associated with greater risk of total mortality.
In patients with stable HF, XSPI, a novel maker of cardiovascular dysfunction, was associated with long-term risk of total mortality.</abstract><cop>United States</cop><pmid>27838626</pmid><doi>10.1093/ajh/hpw133</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Age Factors Aged Aged, 80 and over Blood Pressure Carotid Arteries - physiopathology Female Heart Failure - mortality Humans Hypertension - mortality Male Manometry Middle Aged Natriuretic Peptide, Brain - blood Peptide Fragments - blood Predictive Value of Tests Prognosis Prospective Studies Sex Factors Stroke Volume Taiwan - epidemiology Wavelet Analysis |
title | Excess Pressure Integral Predicts Long-Term All-Cause Mortality in Stable Heart Failure Patients |
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