Does Resting Cardiac Power Index Affect Survival Post Transcatheter Aortic Valve Replacement?

Pradyumna Agasthi, Reza Arsanjani, Farouk Mookadam, Panwen Wang, Nithin R. Venepally, John Sweeney, Mackram Eleid, David R. Holmes, Peter Pollak, Floyd David Fortuin

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

OBJECTIVE: Cardiac power index (CPI) is an integrative hemodynamic measure of cardiac pumping capability and is the product of the simultaneously measured mean arterial pressure and the cardiac output. We assessed the association between baseline resting CPI and survival post transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: We retrospectively abstracted data of patients who underwent TAVR at the Mayo Clinic Foundation with follow-up data available at 1 year. Baseline demographic, clinical, and echocardiographic data were abstracted. CPI was calculated using the formula, (cardiac output x mean arterial blood pressure) / (451 x body surface area) W/m². Patients were divided into CPI <0.48 W/m² (group 1) and CPI ≥0.48 W/m² (group 2). Survival according to CPI was determined using Kaplan-Meier method. Multivariate Cox regression analysis was performed to adjust for covariates. Nine hundred and seventy-five patients were included in the final analysis. CPI in group 1 vs group 2 was 0.41 ± 0.05 W/m² vs 0.66 ± 0.14 W/m², respectively (P<.001, two-sided t-test). Patients in group 1 were more likely to be male and to have a prior history of myocardial infarction, coronary revascularization, peripheral arterial disease, diabetes mellitus, transient ischemic attack, carotid artery disease, atrial fibrillation, lower left ventricular ejection fraction, and moderate to severe mitral and tricuspid regurgitation. After adjusting for baseline covariates, a lower CPI was associated with higher 1-year mortality among patients undergoing TAVR (24.39% in group 1 vs 8.28% in group 2; P<.001). CONCLUSION: Low baseline CPI (<0.48 W/m²) confers higher mortality risk among patients undergoing TAVR and provides additional prognostic information, which can help risk-stratify patients.

Original languageEnglish (US)
Pages (from-to)129-137
Number of pages9
JournalThe Journal of invasive cardiology
Volume32
Issue number4
StatePublished - Apr 1 2020

Keywords

  • aortic valve replacement
  • cardiac power
  • mortality
  • risk stratification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Agasthi, P., Arsanjani, R., Mookadam, F., Wang, P., Venepally, N. R., Sweeney, J., Eleid, M., Holmes, D. R., Pollak, P., & Fortuin, F. D. (2020). Does Resting Cardiac Power Index Affect Survival Post Transcatheter Aortic Valve Replacement? The Journal of invasive cardiology, 32(4), 129-137.