Abstract 15074: Systemic Pulse Pressure to Central Venous Pressure Ratio is Associated With Adverse Clinical Outcomes in Advanced Heart Failure

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A15074-A15074
• Main Authors: Cutts, Jamey, Bilchick, Kenneth C, Miller, Matt, Aktan, Idil, Stafford, Patrick, Abeya, Fardous, Kwon, Younghoon, Mehta, Nishaki M, Noutong, Steve, David, Sthuthi, Breathett, Khadijah, Mubanga, Mwenya, Mwansa, Hunter, Mazimba, Sula
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.15074

IntroductionAdvanced heart failure (AHF) is associated with poor contractile function, low pulse pressure, and central venous congestion.HypothesisSystemic pulse pressure (SPP) when indexed to central venous pressure (CVP) would be associated with adverse outcomes in AHF.MethodsWe analyzed 165 patients with advanced decompensated heart failure from the ESCAPE trial database with complete hemodynamic data for calculation of SPP (systemic systolic pressure - diastolic pressure) / CVP. Cox proportional hazards regression was used to evaluate the association of SPP/CVP for the combined outcome of death, transplant, and left ventricular assist device implantation (DTxLVAD), as well as combined DTxLVAD and re-hospitalization (DTxLVADRH). We performed Cox proportional hazards regression to determine these associations and performed survival analysis using Kaplan-Meier analysis with the log-rank statistic.ResultsAmong 165 patients, the mean age was 56.7 years (SD +/- 13.6 years). The median SPP and SPP/CVP were 37.0 mm Hg (IQR 30-46) and 3.0 (IQR 1.8-5.2), respectively. Increasing SPP/CVP was associated with decreased risk of both DTxLVAD (HR 0.86, 95% CI 0.75-0.99, P=0.04) and DTxLVADRH (HR 0.93, 95% CI 0.88-0.98, P=0.005), although the effect on the hospitalization outcome was dominated by the SPP component of the ratio (P