Die lokale Wetterprognose

Börnstein, Richard

doi:10.1007/978-3-642-99596-5

1884

DOI: 10.1007/978-3-642-99596-5

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Die lokale Wetterprognose

Richard Börnstein¹

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2014

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“…A ugmented contractility of postextrasystolic heartbeats has been described almost 130 years ago 1,2 and later termed postextrasystolic potentiation (PESP). 3,4 For almost 1 century, PESP was thought to reflect normal cardiac function. 5 However, during the second half of the previous century, an increasing number of reports showed that, measured at the blood pressure (BP) level, PESP is a typical finding in heart failure (HF) patients.…”

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Postextrasystolic Blood Pressure Potentiation Predicts Poor Outcome of Cardiac Patients

Sinnecker

Dirschinger

Barthel

et al. 2014

JAHA

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BackgroundPostextrasystolic blood pressure potentiation (PESP), the pulse wave augmentation after an extrasystolic beat, is typically enhanced in heart failure (HF) patients. This study prospectively tested the association of PESP and mortality in cardiac patients.Methods and ResultsConsecutive patients (n=941; mean age, 61 years; 19% female) presenting with acute myocardial infarction were enrolled between May 2000 and March 2005 and followed up until August 2010. The main study outcome was 5‐year all‐cause mortality. Patients underwent noninvasive 30‐minute recordings of ECG and continuous blood pressure. PESP presence was based on the ratio between the first postectopic pulse wave amplitude and the mean of the subsequent 9 pulse wave amplitudes. A ratio above 1 was prospectively defined as PESP present. Ventricular premature complexes (VPCs) suitable for PESP quantification were present in recordings of 220 patients. PESP was present in 62 of these patients. Patients without suitable VPCs were classified as PESP absent.During the follow‐up, 72 patients died. Among the 220 patients in whom PESP was measurable, 27 died. Under univariable analysis, PESP was a significant predictor of death (P<0.001) as were GRACE score (P<0.001), left ventricular ejection fraction (LVEF) (P<0.001), and the number of recorded VPCs (P<0.001). Under multivariable analysis, PESP (P<0.001), GRACE score (P<0.001), and LVEF (P=0.001) were independently associated with outcome. The combination of PESP presence and LVEF ≤35% identified a subgroup of patients with a particularly high mortality of 46.7%. Separate validation reproduced the finding in an unrelated population of 146 HF patients.ConclusionsPESP, which likely reflects abnormalities of myocardial calcium cycling, predicts the mortality risk in postinfarction patients.Clinical Trial RegistrationURL: ClinicalTrials.gov. Unique identifier: NCT00196274.

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confidence: 99%

Postextrasystolic Blood Pressure Potentiation Predicts Poor Outcome of Cardiac Patients

Sinnecker

Dirschinger

Barthel

et al. 2014

JAHA

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Die lokale Wetterprognose

Cited by 1 publication

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Postextrasystolic Blood Pressure Potentiation Predicts Poor Outcome of Cardiac Patients

Postextrasystolic Blood Pressure Potentiation Predicts Poor Outcome of Cardiac Patients

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