Cardiac Power Output, its Role in Defining Heart Failure for Future Mechanical Support

Abstract

Cardiac Power Output (CPO) has shown to effectively indentify declining cardiac performance in Heart Failure (HF) patients. We compared CPO to other commonly used hemodynamic parameters to establish its usefulness in determining when Mechanical Circulatory Support (MCS) is required. A retrospective study of 28 HF patients previously implanted with MCS were analyzed at 3 stages of pharmacological support. Studied subjects were separated into two categories (survived versus deceased) to compare contractile reserve differences in order to predict when complete cardiac dysfunction was met. CPO and Cardiac Power Index (CPI) were the two hemodynamic parameters that identified remaining contractile reserve in the declining heart (p < 0.05). Other commonly used hemodynamic parameters failed to provide information that can detect the need for MCS. Patients who decreased below 0.70 (Watts) had higher incidences of mortality and /or morbidity. Clinicians who cannot medically manage HF patients above 0.70 W may consider MCS as an alternative treatment to retain hemodynamic stability.