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Title: | Prognostic role of cardiac power index in ambulatory patients with advanced heart failure | Authors: | Grodin, Justin L. MULLENS, Wilfried DUPONT, Matthias Wu, Yuping Taylor, David O. Starling, Randall C. Tang, W. H. Wilson |
Issue Date: | 2015 | Publisher: | WILEY-BLACKWELL | Source: | EUROPEAN JOURNAL OF HEART FAILURE, 17 (7), p. 689-696 | Abstract: | BackgroundCardiac pump function is often quantified by left ventricular ejection fraction by various imaging modalities. As the heart is commonly conceptualized as a hydraulic pump, cardiac power describes the hydraulic function of the heart. We aim to describe the prognostic value of resting cardiac power index (CPI) in ambulatory patients with advanced heart failure. Methods and resultsWe calculated CPI in 495 sequential ambulatory patients with advanced heart failure who underwent invasive haemodynamic assessment with longitudinal follow-up of adverse outcomes (all-cause mortality, cardiac transplantation, or ventricular assist device placement). The median CPI was 0.44W/m(2) (interquartile range 0.37, 0.52). Over a median of 3.3years, there were 117 deaths, 104 transplants, and 20 ventricular assist device placements in our cohort. Diminished CPI (<0.44W/m(2)) was associated with increased adverse outcomes [hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.8-3.1, P<0.0001). The prognostic value of CPI remained significant after adjustment for age, gender, pulmonary capillary wedge pressure, cardiac index, pulmonary vascular resistance, left ventricular ejection fraction, and creatinine [HR 1.5, 95% CI 1.03-2.3, P=0.04). Furthermore, CPI can risk stratify independently of peak oxygen consumption (HR 2.2, 95% CI 1.4-3.4, P=0.0003). ConclusionResting cardiac power index provides independent and incremental prediction in adverse outcomes beyond traditional haemodynamic and cardio-renal risk factors. | Notes: | [Grodin, Justin L.; Taylor, David O.; Starling, Randall C.; Tang, W. H. Wilson] Cleveland Clin, Inst Heart & Vasc, Dept Cardiovasc Med, Cleveland, OH 44106 USA. [Tang, W. H. Wilson] Cleveland Clin, Lerner Res Inst, Dept Cellular & Mol Med, Cleveland, OH 44106 USA. [Mullens, Wilfried; Dupont, Matthias] Ziekenhuis Oost Limburg, Dept Cardiol, Genk, Belgium. [Mullens, Wilfried; Dupont, Matthias] Hasselt Univ, Diepenbeek, Belgium. [Wu, Yuping] Cleveland State Univ, Dept Math, Cleveland, OH 44115 USA. | Keywords: | Cardiac power index; Prognosis; Heart failure;cardiac power index; prognosis; heart failure | Document URI: | http://hdl.handle.net/1942/19155 | ISSN: | 1388-9842 | e-ISSN: | 1879-0844 | DOI: | 10.1002/ejhf.268 | ISI #: | 000357519700009 | Rights: | © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2016 |
Appears in Collections: | Research publications |
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