Higher excess pressure integral (XSPI) was independently associated with an increased risk of total mortality in patients with stable heart failure (HR 4.37 per 1 SD; 95% CI 1.31-14.58).
Cohort (n=238)
Does higher excess pressure integral (XSPI) predict long-term all-cause mortality in patients with stable heart failure?
Excess pressure integral (XSPI) derived from carotid pressure waveforms is a significant independent predictor of long-term all-cause mortality in patients with stable heart failure.
Hazard Ratio: 4.37 (95% CI 1.31–14.58)
BACKGROUND: Excess pressure integral (XSPI) derived from reservoir-excess pressure analysis is proposed as a novel indicator of cardiovascular dysfunction in hypertensives. Our study investigated the prognostic value of XSPI for stable heart failure (HF) patients. METHODS: In total, 238 subjects (mean age 63 ± 18 years, 111 male), comprising 168 stable HF patients with either reduced (SHF; n = 64) left ventricular (LV) ejection fraction (EF) or isolated diastolic dysfunction (DHF, n = 104), and 70 healthy controls, were enrolled. Tonometry-derived carotid pressure waveforms were analyzed with the reservoir pressure theory. XSPI was calculated by subtracting the reservoir pressure from carotid pressure waveform. RESULTS: XSPI in SHF and DHF (14.01 ± 5.16 and 13.90 ± 5.05 mm Hg•s) were significantly higher than that in controls (11.01 ± 3.67 mm Hg•s, both P < 0.001). During a median follow-up of 9.9 years, 56 deaths occurred. XSPI was a significant independent predictor of total mortality after adjusting for age, sex, left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio = 4.37 per 1 SD, 95% confidence interval, 1.31-14.58). In subgroup analysis by different baseline characteristics including age, gender, NT-proBNP, LVEF, and GFR, higher XSPI was consistently associated with greater risk of total mortality. CONCLUSION: In patients with stable HF, XSPI, a novel maker of cardiovascular dysfunction, was associated with long-term risk of total mortality.
Wang et al. (Tue,) conducted a cohort in Stable heart failure (n=238). Excess pressure integral (XSPI) was evaluated on Total mortality (HR 4.37, 95% CI 1.31-14.58). Higher excess pressure integral (XSPI) was independently associated with an increased risk of total mortality in patients with stable heart failure (HR 4.37 per 1 SD; 95% CI 1.31-14.58).