Novel Pulse Waveform Index by Ambulatory Blood Pressure Monitoring and Cardiac Function: A Pilot Study.

Background: A simple ambulatory measure of cardiac function could be helpful for monitoring heart failure patients.
Objectives: The purpose of this paper was to determine whether a novel pulse waveform analysis using data obtained by our developed multisensor-ambulatory blood pressure monitoring (ABPM) device, the 'Sf/Am' ratio, is associated with echocardiographic left ventricular ejection fraction (LVEF).
Methods: Multisensor-ABPM was conducted twice at baseline in 20 heart failure (HF) patients with HF-reduced LVEF or HF-preserved LVEF (median age 66 years, male 65%) and over a 6- to 12-month follow-up after patient-tailored treatment. We assessed the changes in the pulse waveform index Sf/Am and LVEF that occurred between the baseline and follow-up. The Sf/Am consists of the area of the ejection part in the square forward wave (Sf) and the amplitude of the measured wave (Am). We divided the patients into the recovered (n = 11) and not-recovered (n = 9) groups defined by a ≥10% increase in LVEF.
Results: Although the ambulatory BP levels and variabilities did not change in either group, the Sf/Am increased significantly in the recovered group (baseline 21.4 ± 4.5; follow-up, 25.6 ± 3.7, P  = 0.004). The not-recovered group showed no difference between the baseline and follow-up. The follow-up/baseline Sf/Am ratio was significantly associated with the LVEF ratio ( r  = 0.469, P  = 0.037). The Sf/Am was significantly correlated with the LVEF in overall measurements (n = 40, r  = 0.491, P  = 0.001).
Conclusions: These results demonstrated that a novel noninvasive pulse waveform index, the Sf/Am measured by multisensor-ABPM is associated with LVEF. The Sf/Am may be useful for estimating cardiac function.
Competing Interests: This study was financially supported in part by A&D Co and by grants from the 10.13039/501100001691Japan Society for the Promotion of Science (JSPS) KAKENHI, nos. JP21K20910 and JP22K16114. Dr Kario has received research funding from Omron Healthcare Co, Fukuda Denshi, and A&D Co. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(© 2024 The Authors.)