Prognostic value of left ventricular stroke work index in patients with advanced heart failure

Abstract

Aim: The impact of reduced myocardial contractility on patients’ outcomes with advanced heart failure (HF) and the correct measurement units for its measure is most important. The present work aims to evaluate the prognostic value of the left ventricular stroke work index (LVSWI), which is considered a measure of myocardial contractility, in patients with advanced HF. Material and Methods: Between September 2010 and July 2013, 172 patients with advanced HF admitted to the hospital to guide the specified therapies were included in this study. At baseline, patients were assessed with cardiac catheterbased hemodynamic measurements, ensued by the longitudinal follow-up (median of 52 months) for adverse outcomes (cardiac mortality, ventricular assist device (VAD) placement, and heart transplant (HTx)). Results: Median LVSWI was 16 cJ/m2. Decreased LVSWI (<16 cJ/m2) was associated with increased adverse outcomes. We observed 50 cardiac deaths, 12 VAD placements and 10 HTx. The prognostic value of LVSWI remained significant after adjustment for age, gender, mean arterial pressure, pulmonary vascular resistance, right atrial pressure and estimated glomerular filtration rate (HR 0.379, 95% CI 0.17-0.84, p=0.017). Conclusion: Lower LVSWI is an independent predictor of adverse outcomes in patients with advanced HF. Therefore, it could be used for individual risk stratification in these patients to predict clinical outcomes.