Cardiac power output predicts mortality across a broad spectrum of patients with acute cardiac disease.
BACKGROUND
Cardiac power output (CPO) is a novel hemodynamic measurement that represents cardiac pumping ability. The prognostic value of CPO in a broad spectrum of patients with acute cardiac disease undergoing pulmonary artery catheterization (PAC) has not been examined.


METHODS
Consecutive patients with a primary cardiac diagnosis who were undergoing PAC in a single coronary care unit were included. The relationship between initial CPO [(mean arterial pressure x cardiac output [CO])/451] and inhospital mortality was evaluated. CPO was analyzed both as a dichotomous variable (using a cutoff value previously established among patients with cardiogenic shock) and as a continuous variable.


RESULTS
Data were available for 349 patients. The mean CPO was 0.88 +/- 0.37 W. The inhospital mortality rate was significantly higher among patients with a CPO < or = 0.53 W (n = 53) compared with those with a CPO > 0.53 W (n = 296) (49% vs 20%, P < .001). In separate multivariate analyses, both CPO and CO were associated with inhospital mortality. However, when both terms were included simultaneously, CPO remained strongly associated with mortality (odds ratio 0.63, 95% CI 0.43-0.91, P = .01), whereas CO did not (odds ratio 1.05, 95% CI 0.75-1.48, P = .78).


CONCLUSIONS
Cardiac power output is a strong, independent predictor of inhospital mortality in a broad spectrum of patients with primary cardiac disease undergoing PAC.
Mendoza
Dorinna D
DD
Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
Cooper
Howard A
HA
Panza
Julio A
JA
D000208:Acute Disease; D000368:Aged; D002302:Cardiac Output; D005260:Female; D006331:Heart Diseases / Q000401:mortality* / Q000503:physiopathology*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000401:mortality / Q000503:physiopathology; D016019:Survival Analysis