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Titolo:
Prognostic value of baroreflex sensitivity assessed by phase IV of Valsalva manoeuvre in patients with mild-to-moderate heart failure
Autore:
Rostagno, C; Galanti, G; Felici, M; Maccherini, M; Sani, G; Caciolli, S; Gensini, GF;
Indirizzi:
Univ Florence, Ist Clin Med & Cardiol, I-50134 Florence, Italy Univ Florence Florence Italy I-50134 & Cardiol, I-50134 Florence, Italy Univ Siena, Ist Cardiochirurg, Policlin Le Scotte, I-53100 Siena, Italy Univ Siena Siena Italy I-53100 Policlin Le Scotte, I-53100 Siena, Italy
Titolo Testata:
EUROPEAN JOURNAL OF HEART FAILURE
fascicolo: 1, volume: 2, anno: 2000,
pagine: 41 - 45
SICI:
1388-9842(200003)2:1<41:PVOBSA>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
MYOCARDIAL-INFARCTION; CARDIOVASCULAR MORTALITY; MANEUVER;
Keywords:
heart failure; baroreceptors; risk stratification;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Rostagno, C Univ Florence, Ist Clin Med & Cardiol, Viale GB Morgagni 85, I-50134 Florence, Italy Univ Florence Viale GB Morgagni 85 Florence Italy I-50134 aly
Citazione:
C. Rostagno et al., "Prognostic value of baroreflex sensitivity assessed by phase IV of Valsalva manoeuvre in patients with mild-to-moderate heart failure", EUR J HE FA, 2(1), 2000, pp. 41-45

Abstract

Background: In patients with heart failure, impairment of baroreflex function occurs early and contributes to sympathetic activation, however, at present its prognostic role has not been definitively established. Aims: To evaluate the prognostic significance of baroceptor impairment in patients with different degrees of heart failure. Methods: We enrolled 52 consecutive patients with heart failure, referred to our institution for functional evaluation. Twenty-eight suffered from ischemic cardiomyopathy and 26 from dilated cardiomyopathy. Thirteen patients were in NYHA class I, 20 in NYHA class II and 19 in class III. All patients underwent baroreflex assessment by phase IV Valsalva manoeuvre using Finapres finger monitoring of arterial blood pressure, echocardiography [with evaluation of left ventricular ejectionfraction (LVEF), fractional shortening (LVFS), left ventricular end diastolic diameter (LVEDD) and mean pulmonary artery pressure] and functional evaluation by cardiopulmonary exercise test and 6-min walk corridor test within 2 days of hospital admission. Results: Mean duration of follow-up was 26 months (range 6-35 months). At baseline, evaluation in 13 patients BRS was normal (> 5 ms/mmHg), in 17 moderately impaired (1.5-5 ms/mmHg) and in 22 severely depressed(< 1.5 ms/mmHg). Baroreflex function was relatively preserved in patients in NYHA class I (5.1 +/- 2.5) in comparison to patients in NYHA class II and III (2.1 +/- 2.3 and 2.08 +/- 1.9 ms/mmHg, respectively). Of the 52 patients who entered the study at the end of follow-up 15 died of cardiac cause and 5 underwent heart transplantation. Survival free from heart transplantation was 62% in patients with normal baroreflex function, 62% in patients with moderate impairment of baroreflex and 66% in patients with major derangement. NYHA class, LVEF, LVFS and LVEDD were significantly associated with event free survival while baroreflex function was not. Conclusions: Our results suggest that evaluation of BRS impairment by phase IV Valsalva manoeuvre has limited prognostic value in patients with heart failure. (C) 2000 European Society of Cardiology. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 13:13:29