TY - JOUR
T1 - Pupillary Light Reflex as a New Prognostic Marker in Patients With Heart Failure
AU - Nozaki, Kohei
AU - Kamiya, Kentaro
AU - Matsue, Yuya
AU - Hamazaki, Nobuaki
AU - Matsuzawa, Ryota
AU - Tanaka, Shinya
AU - Maekawa, Emi
AU - Kishi, Takuya
AU - Matsunaga, Atsuhiko
AU - Masuda, Takashi
AU - Izumi, Toru
AU - Ako, Junya
N1 - Funding Information:
Y. Matsue is supported by the Japan Society for the Promotion of Science) Overseas Research Fellowships and received an honorarium from Otsuka Pharmaceutical Co. The other authors have no conflicts to declare.
PY - 2019/3
Y1 - 2019/3
N2 - Background: Autonomic function can be evaluated based on the pupillary light reflex (PLR). However, the relationship between PLR and prognosis in patients with heart failure (HF) remains unclear. This study was performed to examine whether PLR could be used as a prognostic indicator in patients with HF. Methods and Results: A retrospective review was performed in 535 consecutive Japanese patients hospitalized for acute HF (mean age 66.1 ± 13.7 y). PLR was recorded at least 7 days after hospitalization for HF with the use of a pupilometer. Fifty-three patients died over a median follow-up period of 1.3 years (interquartile range 0.6–2.3 y). After adjustment for several preexisting prognostic factors, including Seattle Heart Failure Score (SHFS), PLR as assessed by recovery time (time to 63% redilation) was independently associated with all-cause mortality (hazard ratio 0.50, 95% confidence interval 0.35–0.73; P <.001). The addition of recovery time to SHFS resulted in a significant increase in the area under the curve on receiver-operating characteristic curve analysis (0.69 vs 0.77; P <.001). Conclusions: PLR assessed by recovery time was an independent predictor of mortality and added prognostic information to the SHFS in patients with HF. Our results suggest that PLR may be useful as a new prognostic marker in HF patients.
AB - Background: Autonomic function can be evaluated based on the pupillary light reflex (PLR). However, the relationship between PLR and prognosis in patients with heart failure (HF) remains unclear. This study was performed to examine whether PLR could be used as a prognostic indicator in patients with HF. Methods and Results: A retrospective review was performed in 535 consecutive Japanese patients hospitalized for acute HF (mean age 66.1 ± 13.7 y). PLR was recorded at least 7 days after hospitalization for HF with the use of a pupilometer. Fifty-three patients died over a median follow-up period of 1.3 years (interquartile range 0.6–2.3 y). After adjustment for several preexisting prognostic factors, including Seattle Heart Failure Score (SHFS), PLR as assessed by recovery time (time to 63% redilation) was independently associated with all-cause mortality (hazard ratio 0.50, 95% confidence interval 0.35–0.73; P <.001). The addition of recovery time to SHFS resulted in a significant increase in the area under the curve on receiver-operating characteristic curve analysis (0.69 vs 0.77; P <.001). Conclusions: PLR assessed by recovery time was an independent predictor of mortality and added prognostic information to the SHFS in patients with HF. Our results suggest that PLR may be useful as a new prognostic marker in HF patients.
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U2 - 10.1016/j.cardfail.2018.09.009
DO - 10.1016/j.cardfail.2018.09.009
M3 - Article
C2 - 30244182
AN - SCOPUS:85056478435
SN - 1071-9164
VL - 25
SP - 156
EP - 163
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 3
ER -