A Risk Prediction Model for Mortality in Patients with Dilated Cardiomyopathy
International Journal of Biomedicine. 2018;8(2):118-122.
Originally published June 15, 2018
The aim of this study was to build a risk prediction model for 1-year mortality on the bases of clinical and functional indicators in patients with dilated cardiomyopathy (DCM).
Materials and Methods: The study included 205 patients (aged from 16 to 61 years) with DCM and chronic heart failure in NYHA FC II-IV. The study included the collection of anamnestic data, physical examinations, clinical and biochemical laboratory methods, 12-lead ECG, echocardiography, and Holter ECG monitoring , 6-minute walk test. The duration of follow-up was 3 to 170 months (36.7±5.6). The study end-points were death (sudden death or progression of heart failure) and thromboembolic complications (pulmonary embolism, ischemic stroke, thromboembolism of the vessels of kidneys and lower extremities).
Results: A sequential evaluation of clinical-anamnestic and instrumental data with analysis of the life expectancy and the subsequent construction of a risk prediction model for 1-year mortality by the method of multiple stepwise logistic regression was performed. In accordance with the results of multiple regression analysis, among the clinico-functional parameters, NYHA class III/IV, low blood pressure, a relatively young age, abnormal QRS complex, high-grade ventricular arrhythmias and an increase in LVESV/LVEDV ratio (>0.66) are the most influencing factors for a fatal outcome within 1 year of observation.
- Fomin IV, Ageev FT, Arutyunov GP, Bekenkov YuN. [Epidemiology of chronic heart failure in the European part of the Russian Federation]. Russian Heart Failure Journal. 2010;4:32-42. [Article in Russian].
- Cleland JG1, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, et al.; Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The EuroHeart Failure survey programme- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J. 2003;24(5):442-63. PubMed
- Belenkov YuN, Mareyev VYu, Ageyev FT. Chronic heart failure. Selected lectures on cardiology. M: GEOTAR-Media; 2006. [In Russian].
- Reddan DN, Szczech LA, Tuttle RH, Shaw LK, Jones RH, Schwab SJ, et al. Chronic kidney disease, mortality, and treatment strategies among patients with clinically significant coronary artery disease. J Am Soc Nephrol. 2003;14(9):2373-80. PubMed
- Vayhanskaya TG, Kurushko TV, Sivitskaya LN, Danilenko NG, Shestakova LG, Frolov AV. [Algorithm for diagnosis and treatment of patients with dilated cardiomyopathy]. Russian Heart Failure Journal. 2015;6:344-59. [Article in Russian].
- Rizun LI, Voronina TS, Dombrovskaia AV, Frolova IuV, Blagova OV, Van EIu, et al. [Noncoronary dilated cardiomyopathy after reverse remodeling heart surgery]. Kardiologiia. 2013;53(12):41-6. [Article in Russian]. PubMed
- Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O'Connell J, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93(5):841-2. PubMed
- Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor DW, Berman LB. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J. 1985;132(8):919-23. PubMed
- Shlyakhto EV, Sitnikova MYu. [Modern methods of assessing the prognosis for heart failure]. Russian Heart Failure Journal. 2009;6(56):322-34. [Article in Russian].
- Janashia PH, Kruglov VA, Nazarenko VA, Nikolenko SA. Cardiomyopathy and myocarditis: Textbook. M., 2000. [In Russian].
- Grzybowski J, Bilińska ZT, Ruzyłło W, Kupść W, Michalak E, Szcześniewska D, et al. Determinants of prognosis in nonischemic dilated cardiomyopathy. J Card Fail. 1996;2(2):77-85. PubMed
- Rihal CS, Nishimura RA, Hatle LK, Bailey KR, Tajik AJ. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis. Circulation. 1994;90(6):2772-9. PubMed
- Witte K, Thackray S, Banerjee T, Clark AL, Cleland JG. Update of ELITE-II, BEST, CHAMP, and IMPRESS clinical trials in heart failure. Eur J Heart Fail. 2000;2(1):107-12. PubMed
- Schannwell CM, Schoebel FC, Marx R, Plehn G, Leschke M, Strauer BE. [Prognostic relevance of left ventricular diastolic function parameters in dilated cardiomyopathy]. Z Kardiol. 2001;90(4):269-79. [Article in German]. PubMed
- Yokokawa M, Tada H, Koyama K, Ino T, Hiramatsu S, Kaseno K, et al. The characteristics and distribution of the scar tissue predict ventricular tachycardia in patients with advanced heart failure. Pacing Clin Electrophysiol. 2009;32(3):314-22. doi: 10.1111/j.1540-8159.2008.02238.x. PubMed
- Dawson DK, Hawlisch K, Prescott G, Roussin I, Di Pietro E, Deac M, et al. Prognostic role of CMR in patients presenting with ventricular arrhythmias. JACC Cardiovasc Imaging. 2013;6(3):335-44. doi: 10.1016/j.jcmg.2012.09.012. PubMed
- Levy WC, Mozaffarian D, Linker DT, Sutradhar SC, Anker SD, Cropp AB, et al. The Seattle Heart Failure Model: prediction of survival in heart failure. Circulation. 2006;113(11):1424-33. PubMed
- Kyuma M, Nakata T, Hashimoto A, Nagao K, Sasao H, Takahashi T, et al. Incremental prognostic implications of brain natriuretic peptide, cardiac sympathetic nerve innervation, and noncardiac disorders in patients with heart failure. J Nucl Med. 2004;45(2):155-63. PubMed
Received March 22, 2018.
Accepted April 2, 2018.
©2018 International Medical Research and Development Corporation.