Pulse pressure as a haemodynamic variable in systolic heart failure

Colin James Petrie

    Research output: ThesisThesis fully internal (DIV)

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    Abstract

    In patients with heart failure, the heart is unable to pump enough blood to satisfy the requirements of the body. Explanations for this include heart muscle damage after a heart attack. This could be very recently, or in the past, sometimes dating back many years. In other cases the explanation for the heart failure is unknown, but the end result is similar. Heart failure carries a risk of requiring admission to hospital because of increasing symptoms such as breathlessness, extreme fatigue and swollen legs, as well as death. Being able to identify those at higher risk of such events is important. Blood pressure, a simple parameter measured with a standard blood pressure cuff in every day practice, can identify those at increased risk. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure measurement. When pulse pressure is low, measuring less than about 40mmHg, this identifies patients at the highest risk of death. Our findings are in contradiction to previous research that identified a higher pulse pressure to be harmful. However, that appeared to be in patients with less advanced heart failure. We found that regardless of the cause of the heart failure, this simple parameter is an indication of poor heart function. The low pulse pressure identifies patients with poor heart function and thus only applies to those with the most badly affected hearts. The lower the pulse pressure, the poorer the heart function and with that the highest risk of death.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    Supervisors/Advisors
    • Voors, Adriaan, Supervisor
    • van Veldhuisen, Dirkjan, Supervisor
    Award date12-Sep-2016
    Place of Publication[Groningen]
    Publisher
    Publication statusPublished - 2016

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