69680 20240912131720.0 doi 10.1371/journal.pone.0186152 sideral 101484 ART-2017-101484 eng Ramirez García, Julia Universidad de Zaragoza (orcid)0000-0003-4130-5866 Sudden cardiac death and pump failure death prediction in chronic heart failure by combining ECG and clinical markers in an integrated risk model 2017 Access copy available to the general public Unrestricted Background: Sudden cardiac death (SCD) and pump failure death (PFD) are common endpoints in chronic heart failure (CHF) patients, but prevention strategies are different. Currently used tools to specifically predict these endpoints are limited. We developed risk models to specifically assess SCD and PFD risk in CHF by combining ECG markers and clinical variables. Methods: The relation of clinical and ECG markers with SCD and PFD risk was assessed in 597 patients enrolled in the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study. ECG indices included: turbulence slope (TS), reflecting autonomic dysfunction; T-wave alternans (TWA), reflecting ventricular repolarization instability; and T-peak-to-end restitution (¿aTpe) and T-wave morphology restitution (TMR), both reflecting changes in dispersion of repolarization due to heart rate changes. Standard clinical indices were also included. Results: The indices with the greatest SCD prognostic impact were gender, New York Heart Association (NYHA) class, left ventricular ejection fraction, TWA, ¿aTpe and TMR. For PFD, the indices were diabetes, NYHA class, ¿aTpe and TS. Using a model with only clinical variables, the hazard ratios (HRs) for SCD and PFD for patients in the high-risk group (fifth quintile of risk score) with respect to patients in the low-risk group (first and second quintiles of risk score) were both greater than 4. HRs for SCD and PFD increased to 9 and 11 when using a model including only ECG markers, and to 14 and 13, when combining clinical and ECG markers. Conclusion: The inclusion of ECG markers capturing complementary pro-arrhythmic and pump failure mechanisms into risk models based only on standard clinical variables substantially improves prediction of SCD and PFD in CHF patients. info:eu-repo/grantAgreement/ES/DGA/T96 info:eu-repo/grantAgreement/EC/H2020/638284/EU/Is your heart aging well? A systems biology approach to characterize cardiac aging from the cell to the body surface/MODELAGE This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 638284-MODELAGE info:eu-repo/grantAgreement/ES/MINECO/DPI2016-75458-R info:eu-repo/grantAgreement/ES/MINECO/TIN2013-41998-R info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 2.766 2017 MULTIDISCIPLINARY SCIENCES 14 / 63 = 0.222 2017 Q1 T1 1.164 2017 Agricultural and Biological Sciences (miscellaneous) 2017 Q1 Medicine (miscellaneous) 2017 Q1 Biochemistry, Genetics and Molecular Biology (miscellaneous) 2017 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Orini, Michele Minchole, Ana Monasterio, Violeta (orcid)0000-0001-5343-5671 Cygankiewicz, Iwona Bayes de Luna, Antonio Martinez, Juan Pablo Universidad de Zaragoza (orcid)0000-0002-7503-3339 Laguna, Pablo Universidad de Zaragoza (orcid)0000-0002-1960-407X Pueyo, Esther Universidad de Zaragoza (orcid)0000-0003-3434-9254 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 12, 10 (2017), e0186152 [15 pp.] PLoS One PLoS ONE 1932-6203 2393545 http://zaguan.unizar.es/record/69680/files/texto_completo.pdf Versión publicada 102194 http://zaguan.unizar.es/record/69680/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:69680 articulos driver 2024-09-12-13:15:34 ARTICLE