Xie et al used Doppler echocardiography and clinical findings to predict 1 and 2 year mortality for adults with congestive heart failure. These can help identify a patient who may benefit from more aggressive management. The authors are from the University of Kentucky Medical Center in Lexington.
Parameters:
(1) transmitral flow pattern on Doppler echocardiography, based on:
(1a) early filling wave (E) height in the transmitral flow in cm per second
(1b) late filling wave (A) height in the transmitral flow in cm per second
(1c) deceleration time in milliseconds
(2) gender
(3) NYHA functional class
E/A ratio =
= (E wave height in cm/s) / (A wave height in cm/s)
|
E/A Ratio |
Deceleration Time |
Pattern |
|
<= 1 |
NA |
nonrestrictive |
|
1.01 - 1.99 |
> 140 ms |
nonrestrictive |
|
1.01 - 1.99 |
<= 140 ms |
restrictive |
|
>= 2 |
NA |
restrictive |
|
Parameter |
Finding |
Points |
|
transmitral flow pattern |
nonrestrictive |
0 |
|
|
restrictive |
1 |
|
gender |
male |
0 |
|
|
female |
1 |
|
NYHA functional class |
I, II or III |
0 |
|
|
IV |
1 |
total number of risk factors =
= SUM(points for the 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk of death increases as the number of risk factors increase.
• The relative risk for death at 1 year ranged from 4 to 6 for the 3 factors.
• The relative risk for death at 2 years ranged from 2.3 (female), 4.4 (NYHA IV functional class), and 8.6 (transmitral flow pattern restrictive).
Purpose: To evaluate risk of 1 year mortality in a patient with congestive heart failure (CHF) using the model of Xie et al and Doppler echocardiography.
Specialty: Cardiology
Objective: criteria for diagnosis, severity, prognosis, stage
ICD-10: I50.0,
