Abstract 12571: Additive Value of Pulse Pressure Reserve During Exercise for Triage of Heart Failure With Reduced Ejection Fraction

IntroductionNarrow pulse pressure (PP) at rest is associated with higher mortality in heart failure (HF) but the relevance of PP reserve (PPR) analyzed during exercise is unknown.HypothesisLow PP reserve during exercise testing in HF with reduced ejection fraction (HFrEF) will identify patients with worse outcomesMethodsSingle-center, observational, prospective study of 646 patients with left ventricular ejection fraction(LVEF) 0.05 for each outcome). Adding PPR to exercise parameters without gas exchange created a model that was non-inferior to standard CPET model with gas exchange measurements for prediction of both mortality (AUC0.718 vs. 0.729; p=0.45) and composite outcome (AUC0.694 vs. 0.705; p= 0.38).ConclusionIn HFrEF, lower PPR identifies additional risk to that predicted by peak VO2 and can enhance the power of standard exercise testing to provide important triage for HFrEF in settings where gas exchange analysis during exercise is not available.