The chronic heart failure evolutions: Different fates and routes.
| Autor: | Agostoni P; Centro Cardiologico Monzino, IRCCs, Milan, Italy.; Department of Clinical Sciences and Community Health, Section of Cardiology, University of Milan, Milan, Italy., Chiesa M; Centro Cardiologico Monzino, IRCCs, Milan, Italy.; Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy., Salvioni E; Centro Cardiologico Monzino, IRCCs, Milan, Italy., Emdin M; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.; Cardio-Thoracic Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy., Piepoli M; Department of Clinical Cardiology, IRCCS Policlinico San Donato, Milan, Italy.; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy., Sinagra G; Department of Cardiology, 'Azienda Sanitaria Universitaria Giuliano-Isontina', Trieste, Italy., Senni M; Department of Cardiology, Unit of Cardiology, ASST Papa Giovanni XXIII, Bergamo, Italy., Bonomi A; Centro Cardiologico Monzino, IRCCs, Milan, Italy., Adamopoulos S; Heart Failure and Heart Transplant Units, Onassis Cardiac Surgery Centre, Attica, Greece., Miliopoulos D; Heart Failure and Heart Transplant Units, Onassis Cardiac Surgery Centre, Attica, Greece., Mapelli M; Centro Cardiologico Monzino, IRCCs, Milan, Italy.; Department of Clinical Sciences and Community Health, Section of Cardiology, University of Milan, Milan, Italy., Campodonico J; Centro Cardiologico Monzino, IRCCs, Milan, Italy., Attanasio U; Federico II University, Naples, Italy., Apostolo A; Centro Cardiologico Monzino, IRCCs, Milan, Italy., Pestrin E; Università degli studi di Trieste, Trieste, Italy., Rossoni A; Università degli studi Milano Bicocca, Milan, Italy., Magrì D; Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, 'Sapienza' Università degli Studi di Roma, Rome, Italy., Paolillo S; Dipartimento di scienze biomediche avanzate, Federico II University, Naples, Italy., Corrà U; Department of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno Institute, Veruno, Italy., Raimondo R; Divisione di Cardiologia Riabilitativa, Istituti Clinici Scientifici Maugeri, Varese, Italy., Cittadini A; Department of Translational Medical Sciences, Federico II University, Naples, Italy.; Interdepartmental Center for Gender Medicine Research 'GENESIS', Naples, Italy., Iorio A; Department of Cardiology, Unit of Cardiology, ASST Papa Giovanni XXIII, Bergamo, Italy., Salzano A; Cardiac Unit, AORN A Cardarelli, Naples, Italy.; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK., Lagioia R; UOC Cardiologia di Riabilitativa, Mater Dei Hospital, Bari, Italy., Vignati C; Centro Cardiologico Monzino, IRCCs, Milan, Italy., Badagliacca R; Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Rome, Italy., Filardi PP; Department of Advanced Biomedical Sciences, Federico II University of Naples and Mediterranea CardioCentro, Naples, Italy., Correale M; Department of Cardiology, University of Foggia, Foggia, Italy., Perna E; Dipartimento cardio-toraco-vascolare, Ospedale Cà Granda- A.O. Niguarda, Milan, Italy., Metra M; Department of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Cattadori G; Unità Operativa Cardiologia Riabilitativa, IRCCS Multimedica, Milan, Italy., Guazzi M; University of Milano, Milan, Italy., Limongelli G; Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Naples, Italy., Parati G; Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy.; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy., De Martino F; Unità funzionale di cardiologia, Casa di Cura Tortorella, Salerno, Italy., Matassini MV; Department of Cardiology, Division of Cardiac Intensive Care Unit-Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy., Bandera F; Department of Biomedical Sciences for Health, University of Milano, Milan, Italy.; Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy., Bussotti M; Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Milan, Milan, Italy., Re F; Division of Cardiology, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Rome, Italy., Lombardi CM; Department of Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Scardovi AB; Division of Cardiology, Santo Spirito Hospital, Rome, Italy., Sciomer S; Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Rome, Italy., Passantino A; Division of Cardiology, Istituti Clinici Scientifici Maugeri, Institute of Bari, Bari, Italy., Santolamazza C; Dipartimento cardio-toraco-vascolare, Ospedale Cà Granda- A.O. Niguarda, Milan, Italy., Girola D; Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland., Passino C; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy., Karsten M; Centro Cardiologico Monzino, IRCCs, Milan, Italy.; Programa de Pós-Graduação em Fisioterapia, UDESC, Florianópolis, Brazil., Nodari S; Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia Medical School, Brescia, Italy., Pompilio G; Centro Cardiologico Monzino, IRCCs, Milan, Italy.; Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | ESC heart failure [ESC Heart Fail] 2024 Sep 24. Date of Electronic Publication: 2024 Sep 24. |
| DOI: | 10.1002/ehf2.14966 |
| Abstrakt: | Aims: Individual prognostic assessment and disease evolution pathways are undefined in chronic heart failure (HF). The application of unsupervised learning methodologies could help to identify patient phenotypes and the progression in each phenotype as well as to assess adverse event risk. Methods and Results: From a bulk of 7948 HF patients included in the MECKI registry, we selected patients with a minimum 2-year follow-up. We implemented a topological data analysis (TDA), based on 43 variables derived from clinical, biochemical, cardiac ultrasound, and exercise evaluations, to identify several patients' clusters. Thereafter, we used the trajectory analysis to describe the evolution of HF states, which is able to identify bifurcation points, characterized by different follow-up paths, as well as specific end-stages conditions of the disease. Finally, we conducted a 5-year survival analysis (composite of cardiovascular death, left ventricular assist device, or urgent heart transplant). Findings were validated on internal (n = 527) and external (n = 777) populations. We analyzed 4876 patients (age = 63 [53-71], male gender n = 3973 (81.5%), NYHA class I-II n = 3576 (73.3%), III-IV n = 1300 (26.7%), LVEF = 33 [25.5-39.9], atrial fibrillation n = 791 (16.2%), peak VO Conclusions: Each HF phenotype has a specific disease progression and prognosis. These findings allow to individualize HF patient evolutions and to tailor assessment. (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.) |
| Databáze: | MEDLINE |
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