November 18, 1997Circulation
Arterial Baroreflex Modulation of Heart Rate in Chronic Heart Failure
Why the study?
Is depressed baroreflex sensitivity associated with worse clinical outcomes in patients with chronic heart failure?
Population
282 chronic heart failure patients in sinus rhythm receiving stable medical therapy, mean age 52+/-9 years…
Design
Cohort
Follow-up
mean 15+/-12 months
Authors
Discussion
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Implication
Depressed BRS signals higher-risk chronic HF; extends post-MI data but leaves open incremental value in contemporary cohorts.
Key Points
- This study aims to assess the relationship between baroreflex sensitivity and clinical outcomes in chronic heart failure patients.
- BRS was measured in 282 CHF patients undergoing stable medical therapy with sinus rhythm.
- Follow-up duration was a mean of 15 months, recording primary events such as cardiac death and nonfatal cardiac arrest.
- Data analysis involved regression analysis to explore associations with hemodynamic parameters.
- 78 primary events (27.6%) noted during follow-up, associated with BRS categorization.
- Major derangement in BRS (<1.3 ms/mm Hg) indicated a relative risk of 2.7 (95% CI, 1.6 to 4.7) for poor outcomes.
- BRS proved to be an independent predictor of mortality particularly in patients with severe mitral regurgitation.
Structured PICO
Is depressed baroreflex sensitivity associated with worse clinical outcomes in patients with chronic heart failure?
P
Population
282 chronic heart failure (CHF) patients in sinus rhythm receiving stable medical therapy, mean age 52+/-9 years, NYHA class 2.4+/-0.6, LVEF 23+/-6%.
I
Intervention
Baroreflex sensitivity (BRS) assessment using the phenylephrine technique
O
Outcome
Composite of cardiac death, nonfatal cardiac arrest, and status 1 priority transplantationcomposite
Depressed baroreflex sensitivity is associated with poor survival in chronic heart failure, offering independent prognostic value particularly in patients with severe mitral regurgitation.
Cite This Study
Mortara et al. (1997) studied this question.