Patient selection: systolic heart failure
Predictors of mortality:
(1) central sleep apnea
(2) right ventricular dysfunction (measured by right ventricular ejection fraction)
(3) diastolic blood pressure
|
Parameter
|
Finding
|
Points
|
|
central sleep apnea
|
absent
|
0
|
|
|
present
|
1
|
|
right ventricular dysfunction
|
normal to mild dysfunction
|
0
|
|
|
moderate to severe dysfunction
|
1
|
|
diastolic blood pressure
|
normal or high
|
0
|
|
|
low
|
1
|
where:
• Central sleep apnea was evaluated based on the apnea-hypopnea index (AHI). Survival for patients with an AHI < 5 (90 months) was twice that of someone with an AHI >= 5 (45 months). The lowest survival was for patients with an AHI >= 15 (36 months).
• What constituted a low diastolic blood pressure was not defined. Based on Table 2 it might be < 60 mm Hg.
total number of risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The higher the number of risk factors, the worse the survival.
