In:
Echocardiography, Wiley, Vol. 30, No. 10 ( 2013-11), p. 1172-1179
Abstract:
Although echo Doppler and biomarkers are the most common examinations performed worldwide in heart failure ( HF ), they are rarely considered in risk scores. In outpatients with chronic HF and left ventricular ejection fraction ( LVEF ) ≤45%, data on clinical status, echo Doppler variables, aminoterminal pro‐type B natriuretic peptide (NT‐proBNP), estimated glomerular filtration rate ( eGFR ), and drug therapies were combined to build up a multiparametric score. We randomly selected 250 patients to produce a derivation cohort and 388 patients were used as a testing cohort. Follow‐up lasted 29 ± 23 months. The univariable predictors that entered into the multivariable Cox model were as follows: furosemide daily dose 〉 25 mg, inability to tolerate angiotensin converting enzyme (ACE) inhibitors, inability to tolerate β‐blockers, age 〉 75 years, New York Heart Association (NYHA) 〉 2, eGFR 〈 60 mL/min, NT‐proBNP plasma levels above the median, tricuspid plane systolic excursion (TAPSE) ≤14 mm, LV end‐diastolic volume index (LVEDVi) 〉 96 mL/m 2 , moderate‐to‐severe mitral regurgitation (MR) and LVEF 〈 30%. The scores of prognostic factors were obtained with the respective odds ratio divided by the lower odd ratio: 4 points for furosemide dose, 3 points for age, NT‐proBNP, LVEDVi, TAPSE, 2 points for inability to tolerate β‐blockers, inability to tolerate ACE inhibitors, NYHA, eGFR 〈 60 mL/min, moderate‐to‐severe MR, 1 point for LVEF. The multiparametric score predicted all‐cause mortality either in the derivation cohort (68.4% sensitivity, 79.5% specificity, area under the curve [AUC] 78.7%) or in the testing cohort (73.7% sensitivity, 71.3% specificity, AUC 77.2%). All‐cause mortality significantly increased with increasing score both in the derivation and in the testing cohort (P 〈 0.0001). In conclusion, this multiparametric score is able to predict mortality in chronic systolic HF.
Type of Medium:
Online Resource
ISSN:
0742-2822
,
1540-8175
DOI:
10.1111/echo.2013.30.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2013
detail.hit.zdb_id:
2041033-5
