ArticleESC heart failure2021
Aortic pulsatility index predicts clinical outcomes in heart failure: a sub-analysis of the ESCAPE trial.
Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 30 citations in OpenAlex.
- Haemodynamic effects of istaroxime in SCAI stage B HF-related cardiogenic shock: Insights from the SEISMiC trial.ESC heart failure · 2025Trial
- Improved Prognostic Performance of Cardiac Power Output With Right Atrial Pressure: A Subanalysis of the ESCAPE Trial.Journal of cardiac failure · 2022Trial
- Hypoperfusion-Shock Continuum in Acute Decompensated Heart Failure.Circulation. Heart failure · 2026Review
- Integrated Hemodynamic Measures of Cardiac Function and Association With Clinical Outcomes.JACC. Advances · 2026Article
- Invasive Hemodynamic Monitoring in Acute Heart Failure and Cardiogenic Shock.Reviews in cardiovascular medicine · 2025Review
- Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review.Heart failure reviews · 2025Review
- Novel Hemodynamic Markers and Kidney Function in Patients with Acute Decompensated Heart Failure.Kidney360 · 2025Article
- The current use of vasoactive agents in cardiogenic shock related to myocardial infarction and acute decompensated heart failure.American heart journal plus : cardiology research and practice · 2025Article
- Right Heart Catheterization in Patients With Advanced Heart Failure: Novel Hemodynamic Parameters for Risk Stratification.Korean circulation journal · 2025Article
- Low Aortic Pulsatility Index and Pulmonary Artery Pulsatility Index Are Associated With Increased Mortality in Patients With Dilated Cardiomyopathy Awaiting Heart Transplantation.Korean circulation journal · 2025Article
- Dynamic assessment of left ventricular coupling and myocardial reserve in patients with cardiogenic shock.European heart journal open · 2024Article
- Prognostic Significance of Hemodynamics in Patients With Transposition of the Great Arteries and Systemic Right Ventricle.Circulation. Heart failure · 2024Article
- Hemodynamic management of cardiogenic shock in the intensive care unit.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Review
- PREDICT HF: Risk stratification in advanced heart failure using novel hemodynamic parameters.Clinical cardiology · 2024Article
- Observational
- Advanced hemodynamics for prognostication in heart failure: the pursuit of the patient-specific tipping point.Frontiers in cardiovascular medicine · 2024Article
- Should We Be Using Aortic Pulsatility Index Over Cardiac Power Output in Heart Failure Cardiogenic Shock?Circulation. Heart failure · 2022Article
- Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure.Cardiac failure review · 2022Review
- Aortic Pulsatility Index: A Novel Hemodynamic Variable for Evaluation of Decompensated Heart Failure.Journal of cardiac failure · 2021Article
- Aortic pulsatility index predicts clinical outcomes in heart failure: a sub-analysis of the ESCAPE trial.ESC heart failure · 2021Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsAortic pulsatility index (API), calculated as (systolic-diastolic blood pressure)/pulmonary capillary wedge pressure (PCWP), is a novel haemodynamic measurement representing both cardiac filling pressures and contractility. We hypothesized that API would better predict clinical outcomes than traditional haemodynamic metrics of cardiac function. METHODS AND
resultsThe Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial individual-level data were used. Routine haemodynamic measurements, including Fick cardiac index (CI), and the advanced haemodynamic metrics of API, cardiac power output (CPO), and pulmonary artery pulsatility index (PAPI) were calculated after final haemodynamic-monitored optimization. The primary outcome was a composite endpoint of death or need for orthotopic heart transplant (OHT) or left ventricular assist device (LVAD) at 6 months. A total of 433 participants were enrolled in the ESCAPE trial of which 145 had final haemodynamic data. Final API measurements predicted the primary outcome, OR 0.47 (95% CI 0.32-0.70, P < 0.001), while CI, CPO, and PAPI did not. Receiver operator characteristic analyses of final advanced haemodynamic measurements indicated API best predicted the primary outcome with a cutoff of 2.9 (sensitivity 76.2%, specificity 55.3%, correctly classified 61.4%, area-under-the-curve 0.71), compared with CPO, CI, and PAPI. Kaplan-Meier analyses indicated API ≥ 2.9 was associated with greater freedom from the primary outcome (83.5%), compared with API < 2.9 (58.4%), P = 0.001. While PAPI was also significantly associated, CI and CPO were not.
conclusionsThe novel haemodynamic measurement API better predicted clinical outcomes in the ESCAPE trial when compared with traditional invasive haemodynamic metrics of cardiac function.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.