PULSE-HF: A Simple Clinical and Geriatric Score to Predict Systolic Dysfunction in the Elderly Without Heart Failure
| Autor: | Eduardo R. Perna, Diego Caruso, Claudio R. Majul, Lisandro Pereyra, Matias Manzotti, Angela Romero, María F. Ditata, María E. Esquerro, Carlos Alfredo Engel, Rafael Zamora |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Logistic regression Asymptomatic Ventricular Function Left Coronary artery disease Internal medicine medicine Humans Aged Heart Failure Ejection fraction Receiver operating characteristic business.industry Stroke Volume General Medicine Odds ratio Right bundle branch block medicine.disease Cross-Sectional Studies Heart failure Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Current Problems in Cardiology. 47:101066 |
| ISSN: | 0146-2806 |
| DOI: | 10.1016/j.cpcardiol.2021.101066 |
| Popis: | To develop a clinical score to determine preclinical predictors of systolic dysfunction in an outpatient elderly population without a diagnosis of heart failure (HF). PULSE-HF is a cross-sectional study in elderly at-risk (coronary artery disease, diabetes or hypertension) outpatients without a diagnosis of heart failure (HF). The objective in this population was to develop a clinical score to determine preclinical predictors of systolic dysfunction. Clinical and geriatric variables were analyzed; independent predictive factors in the logistic regression analysis were included for the score calculation. Of the 722 subjects enrolled, 47 (6.5%) had a left ventricular ejection fraction (LVEF)50%, and 15 (2.1%) a LVEF40%. Mean age was 76.5 years (5.18) and 445 (61.6%) were female. Multiple logistic regression analysis identified abnormal Q waves (odds ratio [OR]: 4.36; P = 0.003), cardiomegaly (OR: 3.32; P0.001), right bundle branch block (OR: 2.84; P = 0.011), cognitive dysfunction (OR: 2.14; P = 0.027) and NT-proBNP (OR 5.43; P0.001) as independent predictors of LVEF50%. Two prediction scores were built, without and with NT-proBNP inclusion; the area under ROC curves were 0.70 and 0.76, respectively. As the score increased, the sensitivity decreases but increases specificity, and accuracy (97.17% and 91.64% respectively in ≥6 points). NT-proBNP was associated with an increment in the performance (accuracy of 93.18% for score ≥10). We conclude that a simple score using clinical information might be useful to predicting asymptomatic systolic dysfunction in the elderly. |
| Databáze: | OpenAIRE |
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