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Role of cardiac power in heart failure

Cotter, Gad MD*; Williams, Simon G. MB ChB, MRCP; Vered, Zvi MD, FACC, FESC*; Tan, Lip Bun DPhil, FRCP, FESC

Current Opinion in Cardiology: May 2003 - Volume 18 - Issue 3 - p 215-222
Cardiac failure

The heart is a muscular mechanical pump with an ability to generate both flow (cardiac output) and pressure. The product of flow output and systemic arterial pressure is the rate of useful work done, or power output. Cardiac pumping capability can be defined as the cardiac power output (CPOmax) achieved by the heart during maximal stimulation. Cardiac reserve is the increase in power output as the cardiac performance is increased from the resting to the maximally stimulated state. Recently, several studies have shown that CPOmax, a direct indicator of overall cardiac function, measured directly or as an approximation, is a major determinant of exercise capacity and a most powerful predictor of prognosis for patients with chronic heart failure. The same holds true in acute heart failure, where it is also useful in subclassifying the conditions to select the appropriate treatment.

*The Cardiology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel; Unit of Molecular Vascular Medicine, Leeds University, Leeds General Infirmary, Leeds, UK.

Correspondence to Gad Cotter, MD, the Cardiology Department, Assaf-Harofeh Medical Center, 70300, Zerifin, Israel; e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.