Fukuda et al reported the Cardiac Status Score (CSS) in patients following acute myocardial infarction. This is a measure of cardiac functional status and is predictive of adverse outcomes. The authors are from National Hospital Organization Zentsuji Hospital in Japan.
Patient selection: acute myocardial infarction
Patient assessment: Doppler echocardiography
Parameters from Doppler ultrasonography:
(1) peak early diastolic velocity of the mitral inflow in cm per second = E
(2) peak early diastolic longitudinal velocity at the mitral annulus in cm per second = e'
(3) peak systolic longitudinal velocity at the mitral annulus in cm per second = s'
E to e' score =
= (E in cm per second) / (e' in cm per second)
|
Parameter
|
Finding
|
Points
|
|
E to e/ ratio
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< 3
|
3
|
|
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3 to 20
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ROUND(value,0)
|
|
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> 20
|
20
|
|
s'
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< 3
|
3
|
|
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3 to 20
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ROUND(value,0)
|
|
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> 20
|
20
|
cardiac status score =
= (points for E to e' ratio) - (points for s')
Interpretation:
• minimum CSS: -17
• maximum CSS: 17
• The prognosis was worse when the score was >= 3.
• The survival at 6 months was 60% if the CSS was >= 3 versus 95% if less.
Predictors of adverse events after the AMI:
(1) cardiac status score >= 3.0
(2) LVEF <= 45%
(3) eGFR <= 60 mL per minute
Performance:
• The area under the ROC curve was 0.75.
