Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
Key Laboratory of Clinical Research for Cardiovascular Medications, National Health Committee, Beijing, China.
J Cardiovasc Transl Res. 2024 Apr;17(2):448-457. doi: 10.1007/s12265-023-10429-y. Epub 2023 Aug 29.
Cardiac power output (CPO) is a powerful predictor of adverse outcomes in heart failure (HF). However, the original formula of CPO included the difference between mean arterial pressure and right atrial pressure (RAP). The prognostic performance of RAP-corrected CPO (CPO) remains unknown in heart failure with preserved ejection fraction (HFpEF). We studied 101 HF patients with a left ventricular ejection fraction > 40% who had pulmonary hypertension due to left heart disease. CPO was significantly more discriminating than CPO in predicting outcomes (Delong test, P = 0.004). Twenty-five (24.8%) patients presented with dis-concordantly high CPO and low CPO when stratified by the identified CPO threshold of 0.547 W and the accepted CPO threshold of 0.803 W. These patients had the lowest RAP, and their cumulative incidence was comparable with those with concordantly high CPO and CPO (P = 0.313). CPO might identify patients with right ventricular involvement, thereby providing better prognostic performance than CPO in HFpEF.
心输出量（CPO）是心力衰竭（HF）不良结局的有力预测因子。然而，CPO 的原始公式包括平均动脉压与右心房压（RAP）之间的差异。在射血分数保留的心力衰竭（HFpEF）中，RAP 校正的 CPO（CPO）的预后性能仍不清楚。我们研究了 101 例左心室射血分数＞40%的因左心疾病而患有肺动脉高压的 HF 患者。CPO 在预测结局方面明显优于 CPO（Delong 检验，P=0.004）。当按确定的 CPO 阈值 0.547 W 和可接受的 CPO 阈值 0.803 W 分层时，有 25（24.8%）例患者出现 CPO 与 CPO 不一致的高值。这些患者的 RAP 最低，其累积发生率与 CPO 和 CPO 一致的患者相当（P=0.313）。CPO 可能识别出右心室受累的患者，从而在 HFpEF 中提供比 CPO 更好的预后性能。
