In:
Russian Journal of Cardiology, Silicea - Poligraf, LLC, Vol. 27, No. 2S ( 2022-05-20), p. 5005-
Abstract:
Aim . To assess hemodynamic response to active standing test (AST) with beat-to-beat blood pressure (BP) monitoring, their association with office BP and symptoms of orthostatic intolerance in patients with heart failure (HF). Material and methods . Outpatient HF patients with documented left ventricular ejection fraction 〈 40%, followed up in a HF center and receiving optimal medical therapy, underwent AST with beat-to-beat non-invasive BP monitoring. Hemodynamic response was assessed according to the European Federation of Autonomic Societies criteria. Results . The study included 87 patients (mean age, 57±10 years; men, 76%). Normal hemodynamic response to orthostatic stress was observed in 36 (41,4%) patients. Pathological response prevailed during the first minute of orthostatic stress — initial orthostatic hypotension (OH) (n=29, 33,3%) and delayed BP recovery (n=18, 20,7%). Classical OH was detected in 4 (4,6%) patients. There was no orthostatic hypertension, defined as an increase in systolic BP (SBP) ≥20 mm Hg. According to office BP, hypotension was observed in 19 (21,8%) patients (SBP 〈 90 mm Hg in 4 patients and 90-100 mm Hg in 15), hypertension (SBP 〉 140 mm Hg) in 11 (12,6%) patients. Pathological response to orthostatic stress were more often observed in office SBP 〉 140 mm Hg compared to SBP ≤140 mmHg (90,9% and 53,9%, p=0,020). Orthostatic intolerance was noted in 43 (49,4%) patients and were not associated with the level of office SBP (p=0,398) or pathological responses to orthostatic stress (p=0,758 for initial OH and p=0,248 for delayed BP recovery). Conclusion . The pathological hemodynamic response in AST with beat-to-beat BP monitoring in ambulatory patients with HF is most often represented by initial OH and delayed BP recovery associated with office SBP 〉 140 mmHg. The frequency of symptoms of orthostatic intolerance did not differ between groups depending on the presence of an inadequate response to orthostatic stress.
Type of Medium:
Online Resource
ISSN:
2618-7620
,
1560-4071
DOI:
10.15829/1560-4071-2022-5005
Language:
Unknown
Publisher:
Silicea - Poligraf, LLC
Publication Date:
2022
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