Gasparini et al reported the VALID-CRT score for evaluating a patient with an implanted cardiac resynchronization device. This can help to identify a patient with heart failure who may benefit from more aggressive management. The authors are from multiple institutions in Italy, Switzerland and England.
Patient selection: systolic heart failure in (1) NYHA class III, (2) ambulatory IV, or (3) II plus recent hospitalization for CHF; with normal sinus rhythm or atrial fibrillation
Outcome: 2-year and 5-year mortality
Parameters:
(1) age in years
(2) left ventricular ejection fraction (LVEF) in percent
(3) cardiac rhythm
(4) implantable cardioverter-defibrillator (ICD)
(5) gender
(6) coronary artery disease (CAD)
(7) NYHA class
(8) diabetes
Parameter
Finding
Points
age
0.028 * ((age) - 66)
LVEF
-0.044 * ((LVEF) -25)
cardiac rhythm
normal sinus
0
atrial fibrillation
0.646
atrial fibrillation and atrioventricular junction ablation (AVJA)
-0.154
ICD
no
0
yes
-0.656
gender
female
0
male
0.405
CAD
no
0
yes
0.317
NYHA class
II
0
III or IV
0.844
diabetes
no
0
yes
0.167
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score specified: -1.841 (depends on LVEF)
• maximum score specified: 3.157
• The higher hte score the greater the mortality.
Total Score
Quintile for Index
5-Year Mortality
< 0.061
1
10%
0.062 to 0.558
2
19%
0.559 to 0.937
3
28%
0.938 to 1.364
4
36%
> 1.364
5
59%
Performance:
• The area under the ROC curve is 0.70.
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