Clinical & Experimental Cardiology
Open Access

Abstract

Rate Pressure Product and Severely Impaired Systolic Function in Heart Failure Patients (Heart Failure and Severe Systolic Dysfunction)

Ibtesam Ibrahim El-Dosouky and Hala Gouda Abomandour

Background: Rate Pressure Product (RPP) is an independent index of cardiac work. We aimed to assess the significance of the RPP in patients with chronic Heart Failure (HF) and its relation to their Echocardiographic findings.
Methods: This prospective study included 358 patients with chronic HF 201 (56.1%) HF preserved Ejection Fraction (HFpEF) and 157 (43.9%) HF reduced EF (HFrEF)], as 3 groups; average resting RPP 7-10 (n=229), high resting RPP>10 (n=88) and low resting RPP <7 (n=41). NYHA class, Heart Rate (HR), blood pressure, RPP were estimated, S3 and rales were evaluated. Echocardiographic parameters; Left Ventricular End Diastolic (LVEDd), LV End Systolic dimensions (LVESd), LV-EF and LV-Stroke Volume Index (SVI) were obtained.
Results: Patients with low RRP had significantly higher prevalence of S3, rales, limiting dyspnea and lower EF. Patients with high RPP had significantly higher incidence of left ventricular hypertrophy, the best EF and the lowest SVI. RPP had significant positive correlations with NYHA class, S3, EF, and EPSS. RPP ≤ 7.75 had 79.2% sensitivity and 70% specificity to predict severely impaired systolic function (EF<30%), (AUC=0.80, p<0.001).
Conclusion: RPP could be a readily available easily measured clinical predictor of low EF; RPP at a cut-off value ≤7.75 could be useful to predict severely impaired LV systolic function. With a new emphasis on incorporation of SVI into diagnostic and follow up approach, hand in hand with the EF specifically in those with LVH.