Low pulse pressure as a poor-man's indicator of a low cardiac index in patients with severe cardiac dysfunction
Low pulse pressure as a poor-man's indicator of a low cardiac index in patients with severe cardiac dysfunction
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DOI：
10.2459/jcm.0b013e328365b51e
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发表时间：
2014-04-01
影响因子：
3
通讯作者：
Voors, Adriaan A.
中科院分区：
文献类型：
--
作者：
Petrie, Colin J.;Damman, Kevin;Voors, Adriaan A.
AimsA低脉压（PP）可能反映不良的心输出量（CO），但还没有得到很好的特点，侵入性血流动力学studies.MethodsWe调查PP和心脏指数（CI）之间的关系，在心血管疾病患者，包括那些与正常和受损的心功能。结果平均年龄为59岁，57%为男性，平均（SD）PP为65（25）mmHg，平均（SD）CI为2.9（0.8）升/分/米（2）。如果CI大于3 l/min/m（2），则CI与PP之间不存在相关性，如果CI在2和3 l/min/m（2）之间，则相关性较弱（r = 0.161; P < 0.001）。对于CI小于2 l/min/m2的患者，相关性更强（r = 0.414; P < 0.001）。在多变量回归分析中，当心脏指数小于3 l/min/m时，低PP预示低CI（2）。这与潜在的混杂因素无关，包括年龄、性别、高血压、心力衰竭、主动脉瓣狭窄、糖尿病、肾功能、心率、全身血管阻力、左心室舒张末期压和平均动脉压。结论在CI小于3 l/min/m2的患者中，低PP是低CI的标志。在严重心力衰竭和低CO的患者中，PP压力可能作为CO的“穷人”替代物有用。
AimsA low pulse pressure (PP) may reflect poor cardiac output (CO), but has not been well characterized by invasive haemodynamic studies.MethodsWe investigated the relationship between PP and cardiac index (CI) in patients with cardiovascular disease including those with normal and impaired cardiac function. Cardiac catheterization data from 1897 patients was analysed.ResultsMean age was 59 years; 57% were men, mean (SD) PP was 65 (25) mmHg and mean (SD) CI was 2.9 (0.8) l/min/m(2). Correlation between CI and PP was absent if the CI was more than 3 l/min/m(2), with a weak correlation if CI was between 2 and 3 l/min/m(2) (r = 0.161; P < 0.001). For those with a CI of less than 2 l/min/m(2), the correlation was much stronger (r = 0.414; P < 0.001). In a multivariable regression analysis, a low PP predicted a low CI, at cardiac indices of less than 3 l/min/m(2). This was independent of potential confounders, including age, sex, presence of hypertension, presence of heart failure, presence of aortic stenosis, diabetes, renal function, heart rate, systemic vascular resistance, left ventricular end diastolic pressure and mean arterial pressure.ConclusionIn patients with a CI of less than 3 l/min/m(2), a low PP is a marker of a low CI. In patients with severe heart failure and a low CO, PP pressure might be useful as a 'poor-man's' surrogate of CO.