Non-invasive cardiac power measurements in decompensated heart failure in elderly adults: A prospective proof-of-concept study.

In this proof-of-concept study, we evaluated the feasibility of non-invasive estimation of cardiac power metrics-total power, steady power, oscillatory power, and oscillatory power fraction-and compared the prognostic and diagnostic value with established echocardiographic metrics. We prospectively included 29 patients (mean age 76 ± 13 years, 24% women) hospitalized with decompensated heart failure. Left ventricular outflow tract flow waveforms were derived from Doppler echocardiography and synchronized with a continuous arterial pressure waveform from a finger-volume-clamp device (INL382, Finapres Medical Systems B.V., Amsterdam, Netherlands). Total power was computed as the integral of the instantaneous pressure-flow product per second, steady power as mean arterial pressure multiplied by mean flow, and oscillatory power as their difference. All measures were calculated from the same consecutive heartbeats covering three respiratory cycles. The feasibility of obtaining cardiac power metrics was 91%. Total, steady, and oscillatory power predicted short-term all-cause mortality (log rank p < 0.015), whereas left ventricular ejection fraction, global longitudinal strain, and myocardial work indices did not. These findings suggest that cardiac power metrics may be useful in risk stratification and warrant validation in larger cohorts.