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Factors influencing 5‑year survival in patients with mild and moderate CHF: Role of office BP and parameters of 24‑h BP profile in disease prognosis

Kapanadze L. G.1, Gerasimova V. V.1, Mareev Yu. V.1, Rogoza A. N.1, Mareev V. Yu. 2
1 - Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552
2 - Federal State Budgetary Educational Institution of Higher Professional Education “M. V. Lomonosov Moscow State University”, Leninskie Gory 1, GSP-1, Moscow 119991

Keywords: patient survival, prognosis, daily monitoring of arterial pressure, CHF

DOI: 10.18087/rhfj.2013.6.1915

Background. Since CHF has an unfavorable course and mortality of CHF patients is high, defining roles of various factors in CHF prognosis is very important. Aim. Studying the significance of office BP and parameters of 24h BP profile for risk stratification and determination of prognosis in CHF. Materials and methods. For evaluation of factors influencing the prognosis, case reports were retrospectively analyzed for 327 patients with SEHF FC II–III CHF evaluated between 1997 and 2006 at the Department of HF at the A. L. Myasnikov Institute of Clinical Cardiology. These patients were prospectively observed for 5 years after the 24h BP monitoring (BPM). Results. Low levels of office SBP (≤115 mm Hg) and pulse BP (PBP) (≤44 mm Hg) statistically significantly impaired 5year survival of patients with CHF whereas the presence of AH improved prognosis in these patients. A monofactorial analysis showed negative effects on prognosis of low night SBP values (<103 mm Hg), low variability of night SBP (<7.5 mm Hg), and absence of daytime SBP hypotensive episodes. A multifactorial analysis (Cox model) showed that the major factors determining the unfavorable 5year prognosis in CHF patients were FC III CHF, LV EF <35.3 %, absence of ACE inhibitor therapy, and two 24h BPM parameters, low night decrease of SBP (<7.5 mm Hg), and the absence of daytime hypotensive episodes probably due to no therapy with ACE inhibitors. Conclusion. For determining a high risk of all-cause death in CHF patients, in addition to well-recognized indices, 24BPM data on low BP variability and low values of nighttime SBP should be taken into consideration.
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Kapanadze L. G., Gerasimova V. V., Mareev Yu. V. et al. Factors influencing 5‑year survival in patients with mild and moderate CHF: Role of office BP and parameters of 24‑h BP profile in disease prognosis. Russian Heart Failure Journal. 2013;14 (6):353-361

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