This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nohria, A. Articles by Stevenson, L. W. Search for Related Content PubMed PubMed Citation Articles by Nohria, A. Articles by Stevenson, L. W.

Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure

^* Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

View larger version (25K): [in a new window]   Figure 1 Schematic for assessment of clinical profiles. Congestion was assessed by the presence of orthopnea, jugular venous distention, rales, hepatojugular reflux, ascites, peripheral edema, leftward radiation of the pulmonic heart sound, or a square-wave blood pressure response to the Valsalva maneuver. Compromised perfusion was assessed by the presence of a narrow proportional pulse pressure, pulsus alternans, symptomatic hypotension (without orthostasis), cool extremities, and/or impaired mentation.

View larger version (24K): [in a new window]   Figure 2 Kaplan-Meier survival curves according to the clinical profiles. The end points were one-year mortality (Panel A) and one-year mortality plus urgent transplantation (Panel B). In both panels, profile C conferred the worst outcomes, followed by profile B, which was worse than profile A. Profile L had too few patients for meaningful statistical analysis. Panel A: *p = 0.002 for profile A versus profile B, p = 0.008 for profile B versus profile C, p < 0.001 for profile A versus profile C. Panel B: *p = 0.002 for profile A versus profile B, p = 0.005 for profile B versus profile C, p < 0.001 for profile A versus profile C.

View larger version (22K): [in a new window]   Figure 3 Kaplan-Meier survival curves according to the clinical profiles in patients with New York Heart Association functional class III/IV heart failure. The end point shown is one-year mortality + urgent transplantation. Patients with profiles B and C had worse outcomes than profile A. Profile L had too few patients for meaningful statistical analysis. The survival for profiles B and C did not differ significantly after Bonferroni correction. *p = 0.015 for profile A versus profile B, p = 0.04 for profile B versus profile C, p < 0.001 for profile A versus profile C.