Abstract 15178: Cardiac Power and the Association With Heart Failure and Cardiovascular Death in the General Population

Abstract

Introduction: Cardiac power (CP) integrates echocardiographic and clinical parameters of hemodynamics, but the prognostic value of CP in the general population remains to be established. Hypothesis: This study investigates the association between CP and incident heart failure (HF) and cardiovascular (CV) mortality in the general population Methods: A total of 4,022 participants without known HF from a general population cohort study was included in the study. CP was calculated by cardiac output x mean blood pressure x 0.222. CP was expressed in W/100 g of LV myocardium. The composite outcome was incident HF or CV death. Cox regression models were used to determine the association of cardiac power with the risk of the composite outcome. Cumulative incidence curves were constructed to visualize the risk of outcome throughout the follow-up period, while accounting for non-cardiovascular death as a competing event. The association was additionally explored in a restricted cubic spline model. Results: During a median follow-up of 3.5 years (IQR 2.6;4.4 years), 134 (3.3%) participants reached the composite outcome. The risk of the composite outcome was significantly increased in those with CP <0.84 W/100 g throughout the follow-up period, while accounting for non-cardiovascular death as a competing event. We found significant interaction between LVEF and CP (p interaction <0.001). When stratifying the population according to LVEF, CP had no prognostic value in LVEF >50% (p=0.74) but in individuals with LVEF < 50%, CP remained an independent prognostic marker after multivariable adjustment (HR 1.20 per 0.1 W/100 g decrease in cardiac power (95% CI: 1.04-1.37, p=0.01) (Figure 1). Conclusion: CP was associated with incident HF and CV death in the general population, however, LVEF significantly modified the relationship between CP and the composite outcome. CP was only independently associated with incident HF and cardiovascular death in participants with LVEF<50%.