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This video is adapted from 10.3390/healthcare10122417
Despite numerous advancements in prevention, diagnosis, evaluation and treatment, cardiovascular disease is the leading cause of morbidity and mortality in the US and globally, and has been for the past 20 years. Due to the high mortality surrounding cardiovascular diseases, there has been extensive research into determining the function and prognostic utility of hemodynamic parameters and biomarkers. Some of the more commonly used prognostic variables include left ventricular ejection fraction (EF), cardiac output (CO), cardiac index (CI), pulmonary capillary wedge pressure (PCWP), blood pressure (diastolic, systolic and/or mean) and brain-natriuretic peptide (BNP). There are several issues, however, with using each of these variables, and their prognostic power varies across cardiac conditions. Both EF and CO/CI are dependent on preload and afterload and may therefore inaccurately represent cardiac function, especially in critical illness such as cardiogenic shock. PCWP captures ventricular compliance and volume status more than actual cardiac pumping ability and it may therefore fail to predict symptomatic improvement or outcome in various cardiac conditions. Similarly, BNP is a measure of ventricular volume overload as opposed to cardiac performance and may therefore be normal in conditions such as heart failure with preserved ejection fraction (HFpEF), CS, and restrictive cardiomyopathies, despite severe disease. By combining both pressure and blood flow, cardiac power (CP) gives a better picture of the overall pumping ability of the heart. It can also be measured noninvasively using echocardiography, a common procedure in the care of cardiac patients and bioimpedance. Specifically, resting CP is easily measured without having to subject patients to additional invasive procedures, which could lead to further decompensation in their condition. CP has been shown to be a powerful predictor of mortality in cardiogenic shock, chronic heart failure and sepsis, among other conditions.