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Prognostic Significance of the Double Pressure Reserve in Patients with Chronic Heart Failure

Ingle, Lee; Clark, Andrew


Andrew Clark


Abstract: Introduction: The double pressure reserve (DPR) has recently been shown to have greater prognostic power
than metabolic equivalents, heart rate indices, and systolic blood pressure in healthy subjects. It is unclear whether DPR
offers any prognostic value in a heart failure population where variables derived from metabolic gas exchange data provide
important prognostic information.
Methods: Patients underwent a symptom-limited, treadmill-based exercise test with metabolic gas exchange measurements
using the modified Bruce protocol. DPR was calculated as the product of peak systolic blood pressure and peak
heart rate subtracted from the product of resting systolic blood pressure and resting heart rate values.
Results: 363 patients (mean ± SD; age 74±11 years; 81% males; left ventricular ejection fraction 34±6%; peak VO2 19.0 ±
5.1 mL·kg-1·min-1; VE/VCO2 slope 37 ± 9; double pressure reserve 10,510 ± 6,046 mmHg·beat-1) were included in the
study. Peak VO2 (hazard ratio (HR) = 0.87; P


Ingle, L., & Clark, A. (2009). Prognostic Significance of the Double Pressure Reserve in Patients with Chronic Heart Failure. Open Heart Failure Journal, 2, 1-5.

Journal Article Type Article
Online Publication Date Apr 1, 2009
Publication Date Jun 17, 2009
Deposit Date May 7, 2019
Publicly Available Date May 29, 2019
Print ISSN 1876-5351
Electronic ISSN 1876-5351
Publisher Bentham Open
Peer Reviewed Peer Reviewed
Volume 2
Pages 1-5
Series Title Open Heart Failure Journal
Public URL
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Copyright Statement
© Ingle and Clark; Licensee Bentham Open.
This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

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