Abstract：
OBJECTIVE: Neurohumoral alterations in heart failure (HF) affect blood pressure variability (BPV) and vascular compliance, but little is known about this subject among patients admitted to the hospital with decompensated HF. This study sought to investigate in-hospital 24-h blood pressure monitoring (BPM)-derived BPV parameters and vascular compliance in patients with decompensated HF and explore the association of these parameters with hospitalization length and in-hospital adverse events.
METHODS: A 24-h BPM was applied during the first 6 h of admission to the hospital in patients with decompensated HF. Circadian patterns were determined by the study patients. Average real variability (ARV), pulse pressure index (PPI), pulse stiffening ratio (PSR), and ambulatory arterial stiffness index (AASI) values were calculated from in hospital 24-h BPM recordings. Admission and discharge N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, length of hospitalization, and in-hospital adverse events were recorded.
RESULTS: A total of 167 patients with decompensated HF were included in the study. The dipper group exhibited a greater NT-proBNP decrease with the treatment than the non-dipper group and reverse dipper group. Hospitalization length was shorter in the dipper group than in the non-dipper and reverse dipper groups. Although ARV, AASI, and PSR were independently associated with the length of hospitalization, ARV, AASI, and PPI were independently associated with in-hospital adverse events.
CONCLUSIONS: The post-admission in hospital 24-h BPM-derived parameters (dipper pattern, ARV, PPI, PSR, and AASI) of patients admitted to hospital with decompensated HF provide important prognostic information and predict the length of hospital stay.
METHODS: A 24-h BPM was applied during the first 6 h of admission to the hospital in patients with decompensated HF. Circadian patterns were determined by the study patients. Average real variability (ARV), pulse pressure index (PPI), pulse stiffening ratio (PSR), and ambulatory arterial stiffness index (AASI) values were calculated from in hospital 24-h BPM recordings. Admission and discharge N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, length of hospitalization, and in-hospital adverse events were recorded.
RESULTS: A total of 167 patients with decompensated HF were included in the study. The dipper group exhibited a greater NT-proBNP decrease with the treatment than the non-dipper group and reverse dipper group. Hospitalization length was shorter in the dipper group than in the non-dipper and reverse dipper groups. Although ARV, AASI, and PSR were independently associated with the length of hospitalization, ARV, AASI, and PPI were independently associated with in-hospital adverse events.
CONCLUSIONS: The post-admission in hospital 24-h BPM-derived parameters (dipper pattern, ARV, PPI, PSR, and AASI) of patients admitted to hospital with decompensated HF provide important prognostic information and predict the length of hospital stay.
摘要：
背景：心力衰竭（HF）的神经体液改变影响血压变异性（BPV）和血管顺应性，但在住院失代偿性HF的患者中，对这一主题知之甚少。这项研究旨在调查住院24小时血压监测（HBPM）衍生的BPV参数和失代偿性HF患者的血管顺应性，并探讨这些参数与住院时间和住院不良事件的关联。
方法：在失代偿性HF患者入院的前6小时内使用24小时血压监测仪。昼夜节律模式由研究患者确定。平均实际变异性(ARV)，脉压指数（PPI），脉冲强化比(PSR),根据HBPM记录计算动态动脉僵硬指数(AASI)值。入院和出院时N末端B型利钠肽原(NT-proBNP)水平,住院时间,并记录院内不良事件.
结果：本研究共纳入了167例失代偿HF患者。与非北斗组和反向北斗组相比，北斗组在治疗过程中显示出更大的NT-proBNP下降。dipper组的住院时间低于非dipper组和反向dipper组。而ARV,AASI,PSR与住院时间独立相关，ARV,AASI,和PPI与院内不良事件独立相关.
结论：入院后HBPM派生参数(北斗星模式，ARV,PPI,PSR,AASI）对失代偿性HF住院的患者提供了重要的预后信息并预测了住院时间。
方法：在失代偿性HF患者入院的前6小时内使用24小时血压监测仪。昼夜节律模式由研究患者确定。平均实际变异性(ARV)，脉压指数（PPI），脉冲强化比(PSR),根据HBPM记录计算动态动脉僵硬指数(AASI)值。入院和出院时N末端B型利钠肽原(NT-proBNP)水平,住院时间,并记录院内不良事件.
结果：本研究共纳入了167例失代偿HF患者。与非北斗组和反向北斗组相比，北斗组在治疗过程中显示出更大的NT-proBNP下降。dipper组的住院时间低于非dipper组和反向dipper组。而ARV,AASI,PSR与住院时间独立相关，ARV,AASI,和PPI与院内不良事件独立相关.
结论：入院后HBPM派生参数(北斗星模式，ARV,PPI,PSR,AASI）对失代偿性HF住院的患者提供了重要的预后信息并预测了住院时间。
