Heart failure & cardiomyopathies
Pupil Reflex as a Marker of Activity and Prognosis in Heart Failure: A Longitudinal and Prospective Study
Authors' conclusion
Pupillometry may be a new, non-invasive, and simple tool to determine the status of SNS, help in the prognostic stratification of acute HF patients, and improve therapeutic management.
Study context
- Population
- Patients admitted with decompensated heart failure (HF)
- Exposure
- Pupillometry in acute HF patients vs healthy controls
- Decompensated HF (admission)n = 107
- Controln = 100reference
- Outcome
- Differences in pupillary reflex (MBPS, MPD) between acute HF patients and controls, and their prognostic value
Methodological detailslongitudinal, consecutive inclusion
- Longitudinal
- Consecutive inclusion
Main finding
As reported in the abstract
Pupillometry: MBPS and MPD
| Group | Maximum baseline pupil size (MBPS) | Minimum pupil diameter (MPD) |
|---|---|---|
| Decompensated HF | 3.64 ± 0.81 | 2.60 ± 0.58 |
| HF at discharge | 3.47 ± 0.79 | 2.51 ± 0.58 |
| Control | 3.34 ± 0.82 | 2.40 ± 0.53 |
Maximum baseline pupil size (MBPS)
Decompensated HF3.64 ± 0.81
HF at discharge3.47 ± 0.79
Control3.34 ± 0.82
Minimum pupil diameter (MPD)
Decompensated HF2.60 ± 0.58
HF at discharge2.51 ± 0.58
Control2.40 ± 0.53
- Decompensated HF higher MBPS and MPD than HF at discharge and controls
- P = 0.01 and 0.01, respectively
- HF at discharge vs controls: no differences in MBPS and MPD
- P = 0.19 and 0.14, respectively
Observational data: associations, not effects.
Further findings
Mortality and readmission in HF patients
- In-hospital death
- 6 (5.61%)
- Death in first month after discharge
- 11 (10.2%)
- Readmission within 1 month of discharge
- 4 (3.74%)
MBPS as predictor of mortality
- ROC for in-hospital mortality (MBPS)
- 0.823
- Deaths with MBPS < 3.7 mm
- 0
- ROC for combined mortality or readmission within first month (MBPS)
- 0.698
- MBPS independent predictor of in-hospital and 1-month mortality
Original publication
Pupil Reflex as a Marker of Activity and Prognosis in Heart Failure: A Longitudinal and Prospective Study. ESC Heart Fail. Published 17 March 2024. doi:10.
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