Background and objectives: The occurrence of an abnormal cardiovascular response during exercise in patients with chronic heart failure is well known. Post-exercise blood pressure response is also useful in assessing the severity of heart failure and impaired exercise capacity. This study evaluated the prognostic significance of post-exercise blood pressure response in patients with dilated cardiomyopathy.
Methods: Thirty patients with dilated cardiomyopathy (left ventricular ejection fraction: 32 +/- 9%) were studied and the relationship between post-exercise blood pressure response and cardiac events (sudden death, heart failure death and readmission for heart failure) were evaluated. The post-exercise blood pressure response was defined as PBP3 (systolic blood pressure at 3 min after exercise divided by peak systolic blood pressure during exercise).
Results: Seven cardiac events (one sudden death, two deaths for heart failure and four readmissions from heart failure) were observed during the follow-up period (3.3 +/- 1.8 years). The PBP3 in patients with these cardiac events was higher than that in patients without cardiac events (0.95 +/- 0.09 vs 0.84 +/- 0.10, p < 0.05). The area under the curve for the receiver-operating characteristic curve with PBP3 used to predict the cardiovascular events was 0.79 (95% confidence interval: 0.62-0.97, p = 0.02).
Conclusions: Post-exercise blood pressure response is a simple and useful predictor of adverse cardiac events in patients with dilated cardiomyopathy.