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Research Snapshot Theater: Cardiovascular, Adult VIII

Cardiac Power Output Predicts Functional Recovery Trajectories in Impella 5.5 Prehabilitation

Monday, March 23, 2026
2:30 PM - 3:30 PM Central Time
Location: Connections Central - RST 02

  • Vrutti Patel, BS (she/her/hers)

    Florida

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • Anek Jena, n/a

    Illinois

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • AP

    Aayushi Pareek, MD

    Research Trainee
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • Saurabh Sujanyal, MBBS

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • SB

    Said Bateh, B.S

    Research Trainee
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • FS

    Faiz Saleem, MD

    Research Fellow
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • Aryan Pathak, BS (he/him/his)

    Florida

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • Rosa Corro, MD (she/her/hers)

    Mayo Clinic Hospital in Florida, Florida

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • GO

    Gustavo A. Olaizola, N/A

    MD
    Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Disclosure information not submitted.

  • Ivan Huespe, MD

    Buenos Aires, Argentina

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • TG

    Timothy Garrahy, APRN

    NURSE PRACTITIONER
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • BL

    Brittney Laskey, PA-C, PA

    PHYSICIAN ASSISTANT
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • TM

    Terri Menser, PhD, MBA

    Senior Associate Consultant in Healthcare Delivery Research
    Mayo Clinic Florida

    Disclosure information not submitted.

  • RG

    Rohan Goswami, MD

    Program Director, Advanced Heart Failure and Transplant
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • TO

    Titilope Olanipekun, MD, MPH

    Brigham and Women's Hospital, Massachusetts

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • ML

    Melissa Lyle, MD

    Transplant Cardiologist
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • PP

    Parag Patel, MD

    Chair, Heart Failure and Transplant
    Mayo Clinic, Jacksonville, Florida

    Disclosure information not submitted.

  • PM

    Pablo Moreno Franco, MD

    Chair, Critical Care Medicine
    Mayo Foundation for Medical Education

    Disclosure information not submitted.

  • Devang Sanghavi, MD, MHA

    Mayo Clinic Hospital in Florida, Florida

    Disclosure information not submitted.

  • AS

    Anna Shapiro, MD

    Consultant, Anesthesiology and Critical Care
    Mayo Clinic Florida

    Disclosure information not submitted.

Introduction: Impella 5.5 enables ambulatory mechanical circulatory support for heart transplant candidates, but predictors of successful prehabilitation are poorly understood. Cardiac power output (CPO), the hydraulic work of the heart, is a powerful indicator in cardiogenic shock. We hypothesized that baseline CPO would predict individualized functional recovery phenotypes during Impella 5.5-supported prehabilitation in heart transplant candidates.


Methods: We conducted a retrospective cohort study of 82 cardiogenic shock patients supported with Impella 5.5 for heart transplant listing from April 2022 to September 2024. CPO was calculated as (mean arterial pressure × cardiac output)/451 and dichotomized at 0.60 W based on established prognostic thresholds. Daily walking distance was monitored during support duration. Longitudinal trajectories were analyzed using linear mixed-effects models with restricted cubic splines to allow for non-linear recovery patterns.


Results: Mean age was 54.9±13.1 years with 83% male patients. Early rapid recovery from 600-700 feet to 5,000-5,500 feet by day 20, followed by plateau was shown by high CPO patients (>0.60 W, n=47). Progressive, persistent improvement from 1,300-1,500 feet to 3,700-3,800 feet by day 45-50 without plateau was shown by low CPO patients (≤0.60 W, n=35). Mixed-effects models confirmed significant non-linear trajectories in both CPO strata (p < 0.001). High CPO patients achieved superior peak functional capacity but plateaued early, while low CPO patients demonstrated sustained adaptive capacity over time.


Conclusions: Baseline cardiac power output effectively stratifies heart transplant candidates into distinct functional recovery phenotypes during Impella 5.5 prehabilitation. High CPO predicts rapid early improvement followed by plateau, while low CPO indicates continued gradual improvement. These findings enable individualized prehabilitation approaches and can help optimize resource allocation in patients awaiting heart transplant with temporary mechanical circulatory support.