Value of Orthostatic Hypotension as a Prognostic Bed-Side Test in Heart Failure

Abstract

Aim: Orthostatic hypotension (OH) has been linked to increased mortality andincidence of cardiovascular disease in various risk groups. Our aim is toidentify the determinants and consequences of OH in the heart failurepopulation as this was poorly studied Methods: Sixty-Four patients with known historyof heart failure were collected. Grouping is based upon wither they have (OH)or not. Group-A found to have normal Bp response to standing; they were 24patients (18 male and 6 female) of mean Age (45 ± 8 years). Group-B discovered tohave significant (OH) and was 22 patients (16 males and 6 females) of mean Age (43 ± 4 years). The first Clinical and Echocardiographic examination was done andconsidered as a base-line characteristic. Then, a Call-back after 6 months forfollow-up and second visit examination is recorded. (Table Presented) Results: In the first visit, comparison of datarevealed no significant variations. In the second visit (6-month later),divergence of data is observed and was statistically significant. Group-B wasfound to have a lower EF% and FS% (p=0.01), a lower Dp/Dt (p=0.01) and a higher Tie-Index and MR-jet area (p=0.01). Indeed, the questionnaire proved frequent times of hospital admissions, paroxysmalnocturnal dysnea, need for treatment modification, arrhythmias and lower limbedema in group-B. Conclusion: The present study conclude that, heartfailure-patients having orthostatic hypotension experienced a significantdeterioration of clinical condition and cardiac functions along a period of six-monthswhich represent failure in their autonomic compensatory mechanisms and possibleimpact on their mortality.