Prognostic Estimation of Advanced Heart Failure With Low Left Ventricular Ejection Fraction and Wide QRS Interval
Korean Circulation Journal
;
: 659-667, 2012.
Artigo
em Inglês
| WPRIM
| ID: wpr-89222
ABSTRACT
BACKGROUND AND OBJECTIVES:
Cardiac resynchronization therapy (CRT) has been known to improve the outcome of advanced heart failure (HF) but is still underutilized in clinical practice. We investigated the prognosis of patients with advanced HF who were suitable for CRT but were treated with conventional strategies. We also developed a risk model to predict mortality to improve the facilitation of CRT. SUBJECTS ANDMETHODS:
Patients with symptomatic HF with left ventricular ejection fraction 120 ms were consecutively enrolled at cardiovascular hospital. After excluding those patients who had received device therapy, 239 patients (160 males, mean 67+/-11 years) were eventually recruited.RESULTS:
During a follow-up of 308+/-236 days, 56 (23%) patients died. Prior stroke, heart rate >90 bpm, serum Na or =1.5 mg/dL were identified as independent factors using Cox proportional hazards regression. Based on the risk model, points were assigned to each of the risk factors proportional to the regression coefficient, and patients were stratified into three risk groups low- (0), intermediate-(1-5), and high-risk (>5 points). The 2-year mortality rates of each risk group were 5, 31, and 64 percent, respectively. The C statistic of the risk model was 0.78, and the model was validated in a cohort from a different institution where the C statistic was 0.80.CONCLUSION:
The mortality of patients with advanced HF who were managed conventionally was effectively stratified using a risk model. It may be useful for clinicians to be more proactive about adopting CRT to improve patient prognosis.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Prognóstico
/
Volume Sistólico
/
Compostos de Mostarda
/
Fatores de Risco
/
Estudos de Coortes
/
Seguimentos
/
Creatinina
/
Acidente Vascular Cerebral
/
Terapia de Ressincronização Cardíaca
/
Coração
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Korean Circulation Journal
Ano de publicação:
2012
Tipo de documento:
Artigo
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