Dziewiecka et al reported a prognostic model for a patient with a dilated cardiomyopathy. The authors are from Jagiellonian University Collegium Medicum, John Paul II Hospital and College of Economics and Computer Science (Krakow) in Poland.
Patient selection: dilated cardiomyopathy
Parameters:
(1) gender
(2) age in years
(3) body mass index (BMI) in kg per square meters
(4) NYHA class
(5) diabetes mellitus
(6) prior stroke
(7) abnormal liver function
(8) dysplipidemia
(9) left bundle branch block (LBBB)
(10) left ventricular end-diastolic diameter (LVEDd) in mm
(11) ejection fraction in percent
(12) NT-proBNPin pg/mL
(13) GFR in mL per min per 1.73 square meters
(14) hemoglobin in g/dL
(15) therapy with ACEI, ARB or ARNI
(16) therapy with mineralocorticoid receptor antagonist (MRA)
(17) digoxin therapy
(18) furosemide daily dose in mg/day
(19) CRT-D/CRT-P (cardiac resynchronization therapy, defibrillator/pacemaker)
(20) symptom duration in months
(21) beta-blocker therapy
|
Parameter |
Finding |
Points |
|
gender |
male |
0 |
|
|
female |
0.442 |
|
age |
|
0.01 * (age) |
|
BMI |
|
0.028 * (BMI) |
|
NYHA class |
I |
0 |
|
|
II |
-0.562 |
|
|
III |
0.046 |
|
|
IV |
-1.398 |
|
diabetes |
no |
0 |
|
|
yes |
-0.868 |
|
prior stroke |
no |
0 |
|
|
yes |
-0.945 |
|
abnormal liver function |
no |
0 |
|
|
yes |
-0.601 |
|
dyslipidemia |
no |
0 |
|
|
yes |
0.559 |
|
LBBB |
no |
0 |
|
|
yes |
-0.816 |
|
LVEDd |
|
(0.154 * (LVEDd)) - (0.001 * ((LVEDd)^2)) |
|
ejection fraction |
|
-0.037 * (EF) |
|
NT-proBNP |
|
-1.054 * LOG10(NTproBNP) |
|
GFR |
|
(0.016 * (GFR)) + (0.886 * (((GFR)/100)^2)) - (1.8 * (((GFR)/100)^3)) |
|
hemoglobin |
|
0.289 (hemoglobin) |
|
ACEI, ARB, ARNI |
no |
0 |
|
|
yes |
1.299 |
|
MRA |
|
(-0.959 * (MRA)) |
|
digoxin |
no |
0 |
|
|
yes |
-0.598 |
|
furosemide |
|
(-0.02 * (furosemide dose)) |
|
CRT-P/CRT-D |
no |
0 |
|
|
yes |
-1.131 |
|
symptom duration |
|
-0.004 * (months) |
|
beta blocker |
no |
0 |
|
|
yes |
-0.934 |
total score =
= SUM(points for all of the parameters)
overall death risk at time t in months =
= 1 - EXP((-1) * X)
X =
= ((time in months) / EXP((0.566 * (score))+4.2)^1.004
where:
• The factor 4.2 is not in the original paper but is required to get the answers given in the examples.
Specialty: Cardiology
