Abstract 16829: Systemic Arterial Pulsatility Index Correlates With Long Term Mortality in Cardiogenic Shock

Abstract

Introduction: Systemic arterial pulsatility index (SAPi) is a marker for ventriculo-arterial coupling that incorporates the contractile properties of the left ventricle with aortic impedance. Prior studies have demonstrated the association of SAPi with adverse outcomes in advanced heart failure. The association of SAPi in cardiogenic shock has not been studied. We evaluated the association of SAPi with mortality in patients with cardiogenic shock with comparison to cardiac output. Methods: Consecutive patients with cardiogenic shock at University of Virginia from 01/2017 to 09/2021 with right heart catheterization data were included in this analysis. Baseline SAPi [systemic systolic blood pressure-systemic diastolic blood pressure]/pulmonary artery wedge pressure] and cardiac output were calculated on admission. Patients were stratified into high and low SAPi based on median SAPi. Cox proportional hazards regression was used to evaluate the association of SAPi stratas with mortality at 1 year. Receiver-operating characteristic (ROC) analysis was performed. Results: Among 120 patients (mean age 55.9, 34.1% female), 40 patients died (33.3%) within 12 months of admission. The median SAPi was 1.96 (IQR 1.25-2.49).Lower values of SAPi were associated with increased mortality at both 1 month (AUC =0.62, p=0.45) and 12 months (AUC =0.63, p=0.02) 12 months mortality with AUC of 0.63 (p=0.02) (Figure 1). The baseline cardiac output was not associated with this survival. Conclusions: In a contemporary cohort of cardiogenic shock patients, low SAPi was associated with increased mortality at both 1 and 12 months after admission for cardiogenic shock and provided better prediction than the baseline cardiac output. Further studies are needed to evaluate the utility of SAPi in hemodynamic monitoring of cardiogenic shock patients. Figure 1