Why the study?
Acute intracerebral hemorrhage often causes a hyperadrenergic response and increased cardiac workload, but the relationship between early cardiac workload and long-term outcomes remains to be assessed.
Does elevated early cardiac workload (rate-pressure product) predict unfavorable functional outcome and mortality in patients with acute intracerebral hemorrhage?
Does elevated early cardiac workload (rate-pressure product) predict unfavorable functional outcome and mortality in patients with acute intracerebral hemorrhage?
Early cardiac workload, measured by the rate-pressure product, is an independent predictor of poor functional outcomes and mortality after intracerebral hemorrhage, an effect that may be attenuated by in-hospital beta-blocker therapy.
Answers are grounded in this paper and cite their sources.
Higher early RPP may flag higher-risk ICH patients; leaves open whether RPP-targeted interventions improve outcomes.
Background:Acute intracerebral hemorrhage (ICH) often induces a hyperadrenergic response, resulting in a significantly increased cardiac workload. This study aimed to assess the relationship between early cardiac workload and long-term outcomes following ICH, utilizing the rate-pressure product (RPP) as a simple surrogate indicator.Methods:We conducted an analysis of data from a large multicenter, prospective cohort comprising 1364 ICH patients. Heart rate (HR) and systolic blood pressure (SBP) were recorded to calculate the RPP. Multivariable logistic regression and Cox proportional hazards models were used to evaluate the associations of RPP with unfavorable functional outcome (modified Rankin Scale score >3) and all-cause mortality at 90 days and 1 year, respectively.Results:Elevated RPP was independently associated with unfavorable functional outcomes and all-cause mortality at 90 days and 1 year (all p < 0.05). RPP exhibited superior predictive performance, as indicated by higher C-statistics for all outcomes when compared to HR or SBP alone (all p < 0.05). A significant interaction was noted with in-hospital β-blocker treatment (p for interaction < 0.05), indicating that the association between high RPP and primary outcomes was attenuated in patients receiving β-blockers.Conclusions:Early cardiac workload, quantified by the RPP, is a potent independent predictor of long-term unfavorable functional outcome and all-cause mortality in patients with ICH.
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Wang et al. (2026) studied this question.
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