Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test

Figures & data

Table 1 Baseline variables for mortality vs alive patients

Parameters	Mortality (mean ± SD), n = 7	Alive (mean ± SD), n = 93	p-value
Age (years)	69.86 ± 7.22	64.02 ± 13.18	0.087
BMI (kg/m^2)	21.77 ± 3.35	24.74 ± 4.52	0.092
SBPr (mmHg)	145.14 ± 38.62	135.18 ± 25.75	0.34
DBPr (mmHg)	87.14 ± 16.04	86.06 ± 15.16	0.86
CTR	0.57 ± 0.05	0.51 ± 0.03	0.04*
PCV (%)	36.71 ± 4.86	38.27 ± 4.73	0.40
Sodium (mmol/L)	136.29 ± 6.90	131.27 ± 10.37	0.21
Potassium (mmol/L)	4.30 ± 0.67	3.91 ± 0.67	0.18
Urea (mmol/L)	5.71 ± 2.07	3.93 ± 1.45	0.003*
Creatinine (μmol/L)	151.57 ± 72.83	103.89 ± 28.22	0.14
eGFR (mL/min)	39.81 ± 22.38	60.69 ± 20.73	0.012*
6-MWDA (m)	167.26 ± 85.24	301.92 ± 49.05	0.006*
LVEF (%)	34.71 ± 13.40	40.05 ± 14.97	0.36
TEI	0.58 ± 0.14	0.52 ± 0.19	0.44
SDNN (ms)	74.43 ± 43.66	109.32 ± 55.48	0.11
PVC (per 24 hours)	16,282.9 ± 9712.5	2622.4 ± 5190.0	0.01*
VT (per 24 hours)	137.57 ± 341.66	6.57 ± 51.10	0.001*

Note:

* p ≤ 0.05 for mortality vs alive.

Abbreviations: BMI, body mass index; SBPr, systolic blood pressure at rest; DBPr, diastolic blood pressure at rest; CTR, cardiothoracic ratio; PCV, packed cell volume; eGFR, estimated glomerular filtration rate; 6-MWDA, 6-minute walk distance on admission; LVEF, left ventricular ejection fraction; TEI, Tei index; VT, ventricular tachycardia on Holter monitoring; SDNN, standard deviation of all normal to normal sinus RR intervals over 24 hours; PVC, premature ventricular contraction.

Table 2 Baseline variables for events vs no events

Parameters	Events (mean ± SD), n = 41	No-events (mean ± SD), n = 59	p-value
Age (years)	61.71 ± 13.46	66.32 ± 12.29	0.079
BMI (kg/m^2)	23.20 ± 4.14	25.46 ± 4.55	0.01*
SBPr (mmHg)	127.46 ± 28.10	141.73 ± 24.24	0.008*
DBPr (mmHg)	81.22 ± 15.68	89.56 ± 13.88	0.006*
CTR	0.54 ± 0.05	0.50 ± 0.02	<0.0001*
PCV (%)	37.95 ± 5.58	38.31 ± 4.07	0.715
Sodium (mmol/L)	132.93 ± 3.80	130.71 ± 12.90	0.289
Potassium (mmol/L)	4.01 ± 0.49	3.89 ± 0.40	0.19
Urea (mmol/L)	4.15 ± 2.07	4.00 ± 1.09	0.61
Creatinine (μmol/L)	112.02 ± 49.18	103.90 ± 12.30	0.32
eGFR (mL/min)	60.54 ± 26.12	58.32 ± 17.61	0.635
6-MWDA (m)	260.59 ± 66.65	314.66 ± 48.17	<0.0001*
LVEF (%)	32.98 ± 13.63	44.34 ± 13.97	<0.0001*
TEI	0.63 ± 0.17	0.46 ± 0.17	<0.0001*
SDNN (ms)	111.00 ± 67.25	104.02 ± 45.58	0.565
PVC (per 24 hours)	7774.0 ± 8414.6	663.2 ± 1872.8	<0.0001*
VT (per 24 hours)	37.98 ± 159.5	0.29 ± 1.70	0.01*

Note:

* p ≤ 0.05 for events vs no-events.

Abbreviations: BMI, body mass index; SBPr, systolic blood pressure at rest; DBPr, diastolic blood pressure at rest; CTR, cardiothoracic ratio; PCV, packed cell volume; eGFR, estimated glomerular filtration rate; 6-MWDA, 6-minute walk distance on admission; LVEF, left ventricular ejection fraction; TEI, Tei index; VT, ventricular tachycardia on Holter monitoring; SDNN, standard deviation of all normal to normal sinus RR intervals over 24 hours; PVC, premature ventricular contraction.

Table 3 Regression analysis among HHF patients for all-cause mortality

Parameters	B	Hazard ratio for Exp (β)	p-value	95% CI for Exp (β)
Urea	1.238	3.448	0.035	1.089–10.919
SigPVC	−3.732	0.024	0.015	0.001–0.485
VT	−0.003	0.997	0.671	0.985–1.01
Atrial fibrillation	−0.485	0.616	0.712	0.047–8.083
eGFR	−0.052	0.949	0.058	0.899–1.002

Abbreviations: HHF, hypertensive heart failure; VT, ventricular tachycardia on Holter monitoring; eGFR, estimated glomerular filtration rate; SigPVC, significant premature ventricular complexes on 24-hour Holter monitoring; CI, confidence interval.

Table 4 Regression analysis for all-cause adverse events

Parameters	B	Odds ratio for Exp (β)	p-value	95% CI for Exp (β)
VT	−2.195	0.111	0.009	0.022–0.576
NYHA	−2.754	0.064	0.001	0.012–0.328
AF	−1.942	0.143	0.028	0.025–0.809
SigPVC	−3.600	0.027	0.017	0.001–0.525
BMI	−0.113	0.893	0.174	0.759–1.051
EF	−0.015	0.985	0.606	0.930–1.044
6-MWDA	−0.200	0.819	0.777	0.206–3.257

Abbreviations: NYHA, New York Heart Association class; BMI, body mass index; EF, ejection fraction; 6-MWDA, 6-minute walk distance on admission; SigPVC, significant premature ventricular complexes on 24-hour Holter monitoring; AF, atrial fibrillation seen on 24-hour Holter monitoring; VT, ventricular tachycardia on Holter monitoring; CI, confidence interval.

Figure 1 Cox regression survival plot for HHF patients based on the presence or absence of significant premature ventricular complexes on 24-hour Holter ECG.

Abbreviations: HHF, hypertensive heart failure; ECG, electrocardiogram; PVC, significant premature ventricular complexes on 24-hour Holter monitoring.

Figure 2 Cox regression survival plot for HHF patients based on the presence of elevated or normal serum urea level.

Abbreviation: HHF, hypertensive heart failure.