ArticleFrontiers in cardiovascular medicine2024
Advanced hemodynamics for prognostication in heart failure: the pursuit of the patient-specific tipping point.
Article in Frontiers in cardiovascular medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Integrated Hemodynamic Measures of Cardiac Function and Association With Clinical Outcomes.JACC. Advances · 2026Article
- Baroreflex Activation Therapy Invasive Hemodynamic "Reverse Ramp" Titration.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Engineering the Future of Heart Failure Therapeutics: Integrating 3D Printing, Silicone Molding, and Translational Development for Implantable Cardiac Devices.Bioengineering (Basel, Switzerland) · 2026Article
- Application of Molecular Hydrogen in Early Heart Failure Development: Modulation of Microcirculation, Metabolism, Oxidative Stress, and Myocardial Status.Antioxidants (Basel, Switzerland) · 2025Article
- The Virtual Patient Simulator: Using Hemodynamics and the Cardioenergetic Profile to Optimize Heart Failure Care.JACC. Basic to translational science · 2025Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
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Abstract
Background: Objective tools to define the optimal time for referral for advanced therapies and to help guide escalation and de-escalation of support can improve management decisions and outcomes for patients with advanced heart failure. The current parameters have variable prognostic potential depending on the patient population being studied and often have arbitrary thresholds. Methods: Here, a mathematical and physiological framework to define the patient-specific tipping point of myocardial energetics is defined. A novel hemodynamic parameter known as the myocardial performance score (MPS), a marker of power and efficiency, is introduced that allows for the objective assessment of the physiological tipping point. The performance of the MPS and other advanced hemodynamic parameters including aortic pulsatility index (API) and cardiac power output (CPO) in predicting myocardial energetics and the overall myocardial performance was evaluated using a validated computer simulation model of heart failure (Harvi) as well as a proof-of-concept clinical validation using a cohort of the Society for Cardiovascular Angiography and Interventions (SCAI) Stage C cardiogenic shock patients. Results: Approximately 1010 discrete heart failure scenarios were modeled. API strongly correlated with the left ventricular coupling ratio ( Conclusions: The MPS, which defines the patient-specific power-to-efficiency ratio and is inversely proportional to PE, represents an objective assessment of the myocardial energetic state of a patient and can be used to define the physiological tipping point for patients with advanced heart failure.
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