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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/19155

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
Citation: 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.
URI: http://hdl.handle.net/1942/19155
DOI: 10.1002/ejhf.268
ISI #: 000357519700009
ISSN: 1388-9842
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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