Heart failure & cardiomyopathies
Pathophysiologic and prognostic importance of cardiac power output reserve in heart failure with preserved ejection fraction
Authors' conclusion
A lower CPO reserve was associated with biventricular systolic dysfunction, chronotropic incompetence, exercise intolerance, and adverse outcomes in patients with HFpEF.
Study context
- Population
- Dyspnoeic patients undergoing exercise stress echocardiography (heart failure with preserved ejection fraction (HFpEF) and non-HF controls)217 HFpEF, 208 controls
- Participants
- 425 patients
- Exposure
- Lower vs higher cardiac power output (CPO) reserve in HFpEF, and vs non-HF controls
- Controlsn = 208reference
- Outcome
- Composite of:
- All-cause mortality
- HF events
- Follow-up
- Median 358 days
Main finding
As reported in the abstract
All-cause mortality or HF events · median 358 days
Hazard ratio (95% CI)P value
Lower CPO reservevs Higher CPO reserve
4.05(1.16–10.1)
P = 0.003Lower CPO reservevs Controls
9.61(3.58–25.8)
P < 0.0001Observational data: associations, not effects.
Further findings
Incremental prognostic value
- Lower CPO reserve added prognostic value over H2FPEF score and exercise duration
Resting CPO
- Resting CPO did not predict outcomes in HFpEF
Cardiac function and exercise capacity
- Lower CPO reserve: poorer biventricular systolic function, impaired chronotropic response and worse aerobic capacity than controls and higher CPO reserve
Original publication
Pathophysiologic and prognostic importance of cardiac power output reserve in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging. Published 21 September 2023. doi:10.
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