期刊
JOURNAL OF HEART AND LUNG TRANSPLANTATION
卷 30, 期 11, 页码 1236-1243出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.healun.2011.05.012
关键词
chronic heart failure; heart transplantation; prognostic model; Heart Failure Survival Score; Seattle Heart Failure Model
资金
- Stockholms Lans Landsting
- Swedish Heart-Lung Foundation, Stockholm, Sweden
- Division of Research Resources, General Clinical Research Centers, National Institutes of Health, Bethesda, MD [5 MO1 RR00645]
- Foundation for Cardiac Therapies, New York, NY
- Altman Fund, New York, NY
BACKGROUND: The Heart Failure Survival Score (HFSS) risk-stratifies patients with chronic heart failure (CHF) referred for heart transplantation using 7 parameters, including peak VO(2): The Seattle Heart Failure Model (SHFM) is a 20-variable model that combines clinical, laboratory and therapeutic data. Although both models have excellent accuracy, only the HFSS was derived and validated in patients referred for transplantation, and the HFSS and SHFM have not been directly compared. METHODS: We tested the accuracy. of the SHFM and compared the HFSS and SHFM in 715 patients referred for heart transplantation. RESULTS: Over a follow-up of 962 +/- 912 days, 354 patients died or received an urgent heart transplantation or a ventricular assist device. One-year event-free survival was 89%, 72% and 60%, respectively, for the low-, medium- and high-risk HFSS strata, and 93%, 76%, and 58%, respectively, for the low-, medium- and high-risk SHFM strata. The HFSS and SHFM were modestly correlated (R = -0.48, p < 0.001). In receiver operating characteristic curve analysis, areas under the curves (AUCs) for the HFSS and SHFM were comparable (1 year: 0.72 vs 0.73; 2-year: 0.70 vs 0.74, respectively) and incremental to New York Heart Association class. The 1- and 2-year combined HFSS+SHFM AUCs were 0.77 and 0.76, respectively, significantly better than the HFSS or SHFM alone. CONCLUSIONS: The HFSS and SHFM provide accurate and comparable risk stratification in CHF patients referred for transplantation. Combining the HFSS and SHFM improves predictive ability. J Heart Lung Transplant 2011;30:1236-43 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.
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