June 10, 2011Journal of Hypertension
Comparison of the prognostic values of invasive and noninvasive assessments of baroreflex sensitivity in heart failure
Key result
Invasive assessment of baroreflex sensitivity (Phe-BRS) had better discriminatory power for cardiac events than noninvasive transfer function BRS (AUC 0.74 vs. 0.66, P=0.03).
Why the study?
Does noninvasive assessment of baroreflex sensitivity (TF-BRS) provide similar prognostic value to invasive assessment (Phe-BRS) for predicting cardiac events in heart failure patients?
Population
301 heart failure patients, mean age 53 ± 8 years, 88% NYHA class II-III, mean LVEF 28 ± 8%
Comparison
Noninvasive assessment of baroreflex sensitivity… vs Invasive assessment of baroreflex sensitivity…
Design
Cohort
Follow-up
median 36 months
Authors
Discussion
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Implication
TF-BRS offers prognostic value in HF but inferior discrimination to Phe-BRS; leaves open its role in routine risk stratification.
Study Design
Type
Cohort (n=301)
Structured PICO
Does noninvasive assessment of baroreflex sensitivity (TF-BRS) provide similar prognostic value to invasive assessment (Phe-BRS) for predicting cardiac events in heart failure patients?
P
Population
301 heart failure patients (mean age 53 years, 88% NYHA class II-III, mean LVEF 28%) followed for a median of 36 months.
E
Exposure
Noninvasive assessment of baroreflex sensitivity using transfer function (TF-BRS)
C
Comparator
Invasive assessment of baroreflex sensitivity using phenylephrine (Phe-BRS)
O
Outcome
Cardiac event at median 36 months follow-uphard clinical
Main Result
Hazard Ratio: 1.9 (95% CI 1.1–3.3)
p-value: p=0.03
Noninvasive transfer function assessment of baroreflex sensitivity provides significant prognostic information in heart failure patients, though invasive phenylephrine assessment has slightly better discriminatory power.
Limitations
- Measurability of transfer function BRS in heart failure patients is impaired due to high grade ectopic activity
Cite This Study
Rovere et al. (2011) conducted a cohort in heart failure (n=301). Invasive assessment of baroreflex sensitivity (phenylephrine) vs. Noninvasive assessment (transfer function) was evaluated on cardiac event (HR 1.9, 95% CI 1.1-3.3, p=0.03). Invasive assessment of baroreflex sensitivity (Phe-BRS) had better discriminatory power for cardiac events than noninvasive transfer function BRS (AUC 0.74 vs. 0.66, P=0.03).