Javaheri et al identified factors predictive of mortality in patients with systolic heart failure. These can help identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from the Veterans Affairs Medical Center and University of Cincinnati in Cincinnati, Ohio.
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.
Specialty: Cardiology
ICD-10: ,