Prognostic utility of pulse pressure in patients with heart failure with preserved ejection fraction: RICA Registry

Background and objective: The prognostic role of pulse pressure (PP) in patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) is not well understood. This study aimed to evaluate it in acute and stable HF.Material and methods: This work is a retrospective observational study of patients included in the RICA registry between 2008 and 2021. Blood pressure was collected on admission (decom-pensation) and at three months (stability). PP was calculated and patients were categorized according to whether PP was greater than/equal to or less than 50 mmHg. All-cause mortality at one year after admission was assessed.Results: A total of 2,291 patients were included. The mean age was 80.1 +/- 7.7 years, 62.9% were women, and 16.7% had a history of ischemic heart disease. In the acute phase, there were no differences in mortality according to PP values, but in the stable phase, PP < 50 mmHg was independently associated with all-cause mortality at one year (HR 1.57, 95% CI 1.21-2.05, p = 0.001) after adjusting for age, sex, New York Heart Association functional class, previous HF, chronic kidney disease, valvular heart disease, cerebrovascular disease, score on the Barthel and Pfeiffer scales, and hemoglobin and sodium levels.Conclusions: Low stable-phase PP was associated with increased all-cause mortality in HF patients with preserved LVEF. However, PP was not found to be a prognostic facture in the acute phase. Further studies are needed to assess the relationship of this variable with mortality in HF patients.(c) 2023 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.