Global work index correlates with established prognostic parameters of heart failure
Felix Hedwig, Sajjad Soltani, Julia Stein, Felix Schoenrath, Evgenij Potapov, Christoph Knosalla, Volkmar Falk, Fabian Knebel, Jan Knierim
Abstract
Abstract Aim Identification of patients with heart failure and a poor prognosis is paramount to ensure timely and adequate treatment. We investigated the relationship between the new measures of noninvasive pressure‐strain analysis, such as the global work index (GWI), and established prognostic parameters of echocardiography, cardiopulmonary exercise test (CPX), and N‐terminal pro‐B‐type natriuretic peptide (NT‐pro‐BNP). Methods and Results We retrospectively analyzed data of 51 patients with heart failure. Echocardiography and CPX were performed, and NT‐pro‐BNP was determined. Patients with a GWI < 500 mm Hg% had a mean LVEDV of 286.1 ± 100.8 mL, an LVEF of 21.3 ± 5.7%, and a stroke volume (SV) of 45.9 ± 11.6 mL, and patients with a GWI > 1000 mm Hg% had an LVEDV of 147.9 ± 39.6 mL, an LVEF of 42.6 ± 4.8%, and a SV of 70.9 ± 14.3 mL. The GWI also showed a significant correlation with peak oxygen consumption (peak VO 2 ) ( r = .521; P < .001) and with NT‐pro‐BNP ( r = .635; P < .001). Patients with a GWI of <500 mm Hg% had a significantly higher NT‐pro‐BNP (median 2415 pg/mL [IQR 1071, 5933]) and a lower peak VO 2 (9.5 mL/min/kg ± 2.6) compared to patients with a GWI of >1000 mm Hg% (NT‐pro‐BNP median 253 pg/mL [IQR 150, 549]; peak VO 2 15.6 ± 4.2 mL/min/kg). Conclusion GWI correlates with known prognostic markers of heart failure. A GWI of <500 mm Hg% was a predictor of severely impaired ejection fraction, very low exercise capacity, and strongly elevated NT‐pro‐BNP, indicating a poor prognosis.