Abstract 12070: Long-term Prognostic Value of Cardiac Power Index in Patients Admitted With Acute Decompensated Heart Failure

Abstract

Backgrounds: Cardiac power is the rate of hydraulic work done by the heart. It has recently been shown that cardiac power index (CPI) provided prognostic independent and incremental prediction in adverse outcomes beyond traditional hemodynamic parameters in ambulatory patients with advanced heart failure. However, there is little information available on the long-term prognostic value of CPI in patients with acute decompensated heart failure (ADHF). Methods and Results: We studied 209 patients admitted for ADHF, who underwent right heart catheterization at the admission and were discharged with survival. CPI was calculated by: CPI W/m 2 = ([mean arterial pressure(mmHg) - [right arterial pressure(mm Hg)] x cardiac output [L/min] x K)/ (BSA m 2 ) where K = 0.0022. During a mean follow-up period of 4.4±3.3 yrs, 50 patients had cardiovascular death (CVD). CPI was significantly lower in patients with than without CVD (0.407±0.138 vs 0.550±0.258 W/m 2 , p=0.0002). Multivariate Cox regression analysis revealed that CPI (hazard ratio 0.092 [95%CI 0.017-0.497], p=0.005) was significantly associated with CVD, independently of body mass index, BUN and serum sodium levels, after adjustment for age, systolic blood pressure, pulmonary vascular resistance, and serum creatinine, albumin, and hemoglobin levels. Patients with low CPI (lowest tertile<0.395 W/m 2 ) had a significantly higher CVD risk than those with middle CPI(0.395-0.565 W/m 2 ) and high CPI (highest tertile: >0.565 W/m 2 ) (41%(28/69) vs 22%(15/70) vs 10%(10/70), p<0.0001, respectively). The adjusted hazard ratio in patients with low CPI was 3.40 (95%CI 1.46-7.92). Conclusions: CPI could provide the long-term prognostic information in patients admitted with ADHF.