African Journal of Internal Medicine

African Journal of Internal Medicine Vol. 1 (1). pp. 001- 009, 2012. © International Scholars Journals 

Full Length Research Paper

Value of orthostatic hypotension as a prognostic bed-side test in heart failure

Tarek M. Abdel Rahman

Department of Cardiology, El Minia University Hospital, Egypt. E-mail: [email protected]

Received 20 October, 2012; Accepted 09 December, 2012

Abstract

Orthostatic hypotension (OH) has been linked to increased mortality and incidence of cardiovascular disease in various risk groups. Our aim is to identify the determinants and consequences of OH in the heart failure population as this was poorly studied. Sixty-Four patients with known history of 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 24 patients (18 male and 6 female) of mean age (45 ± 8 years). Group-B discovered to have 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 and considered as a base-line characteristic. Then, a call-back after 6 months for follow-up and second visit examination is recorded. In the first visit, comparison of data revealed no significant variations. In the second visit (6-month later), divergence of data is observed and was statistically significant. Group-B was found 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, paroxysmal nocturnal dysnea, need for treatment modification, arrhythmias and lower limb edema in group-B. The present study conclude that, heart failure-patients having orthostatic hypotension experienced a significant deterioration of clinical condition and cardiac functions along a period of six-months which represent failure in their autonomic compensatory mechanisms and possible impact on their mortality.

Key words: Orthostatic hypotension, heart failure.