PMID- 23742144
OWN - NLM
STAT- MEDLINE
DCOM- 20140711
LR  - 20161125
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 30
IP  - 10
DP  - 2013 Nov
TI  - A multiparametric clinical and echocardiographic score to risk stratify patients 
      with chronic systolic heart failure: derivation and testing.
PG  - 1172-9
LID - 10.1111/echo.12255 [doi]
AB  - 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 beta-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 beta-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.
CI  - (c) 2013, Wiley Periodicals, Inc.
FAU - Fontanive, Paolo
AU  - Fontanive P
AD  - Cardiovascular Diseases Unit 2, Cisanello Hospital, Pisa, Italy.
FAU - Miccoli, Mario
AU  - Miccoli M
FAU - Simioniuc, Anca
AU  - Simioniuc A
FAU - Angelillis, Marco
AU  - Angelillis M
FAU - Di Bello, Vitantonio
AU  - Di Bello V
FAU - Baggiani, Angelo
AU  - Baggiani A
FAU - Bongiorni, Maria Grazia
AU  - Bongiorni MG
FAU - Marzilli, Mario
AU  - Marzilli M
FAU - Dini, Frank Lloyd
AU  - Dini FL
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130606
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
RN  - 0 (Biomarkers)
RN  - 0 (Natriuretic Peptides)
SB  - IM
MH  - Aged
MH  - Biomarkers/metabolism
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Systolic/*classification/*diagnostic imaging/metabolism/mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Natriuretic Peptides/*metabolism
MH  - Prognosis
MH  - ROC Curve
MH  - Risk Assessment/*methods
MH  - Survival Analysis
EDAT- 2013/06/08 06:00
MHDA- 2014/07/12 06:00
CRDT- 2013/06/08 06:00
PHST- 2013/06/08 06:00 [entrez]
PHST- 2013/06/08 06:00 [pubmed]
PHST- 2014/07/12 06:00 [medline]
AID - 10.1111/echo.12255 [doi]
PST - ppublish
SO  - Echocardiography. 2013 Nov;30(10):1172-9. doi: 10.1111/echo.12255. Epub 2013 Jun 
      6.