Key result
Resting cardiac power index below 0.41 W/m2 linked to higher cardiac mortality in advanced HF.
Why the study?
The study aimed to demonstrate the prognostic role of resting cardiac power index in patients with advanced chronic heart failure.
Does invasively determined resting cardiac power index predict cardiac mortality in patients with advanced chronic heart failure?
Cohort (n=99)
No
Does invasively determined resting cardiac power index predict cardiac mortality in patients with advanced chronic heart failure?
p-value: p=0.003
Invasively determined resting cardiac power index <0.41 W/m2 is a strong independent predictor of cardiac mortality in patients with advanced chronic heart failure.
May support risk stratification in advanced HF; hypothesis-generating and requires prospective validation.
Kontext: Pro stratifikaci rizika pacientĹŻ se srdeÄnĂm selhĂĄnĂm se zaÄaly pouĹžĂvat hemodynamickĂŠ parametry. SrdeÄnĂ vĂ˝kon (cardiac power output, CPO) je ukazatelem vĂ˝konnosti srdce. Index srdeÄnĂ sĂly (cardiac power index, CPI) vyjadĹuje vztah srdeÄnĂho vĂ˝konu a plochy tÄlesnĂŠho povrchu. CĂlem studie bylo prokĂĄzat prognostickou Ăşlohu klidovĂŠho CPI u pacientĹŻ s pokroÄilĂ˝m chronickĂ˝m srdeÄnĂm selhĂĄnĂm. Metody: Do studie byli zaĹazeni pacienti v pokroÄilĂŠm stadiu chronickĂŠho srdeÄnĂho selhĂĄnĂ, s ejekÄnĂ frakcĂ levĂŠ komory < 30 % a ve funkÄnĂch tĹĂdĂĄch III a IV, u nichĹž byla provedena katetrizace pravostrannĂ˝ch i levostrannĂ˝ch srdeÄnĂch oddĂlĹŻ. VyĹĄetĹeno bylo celkem 99 pacientĹŻ; jedinci, jimĹž byla implantovĂĄna centrifugĂĄlnĂ pumpa k podpoĹe funkce levĂŠ komory (left ventricular assist device, LVAD) nebo u nichĹž byla provedena transplantace srdce (heart transplantation, HTx), byli ze studie vylouÄeni, aby bylo moĹžno stanovit dĂŠlku pĹeĹžitĂ bez LVAD a HTx. VĂ˝sledky: Z 99 vyĹĄetĹenĂ˝ch pacientĹŻ byl chirurgickĂ˝ vĂ˝kon v souvislosti s LVAD nebo HTx proveden u 43 pacientĹŻ. Ze zbĂ˝vajĂcĂch 56 pacientĹŻ jich bÄhem sledovĂĄnĂ s mediĂĄnem dĂŠlky 16 mÄsĂcĹŻ zemĹelo 19 (33,9 %). Hodnota CPI byla spojena s ĂşmrtĂm ze srdeÄnĂch pĹĂÄin (0,32 vs. 0,42, p = 0,003). MeznĂ hodnota CPI z hlediska mortality byla 0,41 (senzitivita 89,5 % a specificita 56,8 %). SnĂĹženĂĄ hodnota CPI (< 0,41 W/m2) byla rovnÄĹž spojena s vysokĂ˝m tlakem v pravĂŠ sĂni (p = 0,016) a s plicnĂ cĂŠvnĂ rezistencĂ (p = 0,012). Kaplanova-Meierova analĂ˝za pĹeĹžitĂ prokĂĄzala, Ĺže dlouhodobĂŠ pĹeĹžitĂ je statisticky vĂ˝znamnÄ kratĹĄĂ u pacientĹŻ s CPI < 0,41. ZĂĄvÄr: KlidovĂ˝ CPI je u pacientĹŻ s pokroÄilĂ˝m chronickĂ˝m srdeÄnĂm selhĂĄnĂm spojen s ĂşmrtĂm ze srdeÄnĂch pĹĂÄin. © 2023, ÄKS.
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Doğan et al. (2023) conducted a cohort in Advanced chronic heart failure (n=99). Resting cardiac power index (CPI) vs. CPI ≥ 0.41 W/m2 was evaluated on Cardiac mortality (p=0.003). A resting cardiac power index below 0.41 W/m2 was significantly associated with increased cardiac mortality (AUC 0.745, p=0.003) in patients with advanced chronic heart failure.
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