Navigation Links
UCLA researchers develop risk calculator to predict survival in heart failure patients
Date:1/22/2014

A UCLA team has developed an easy-to-use "risk calculator" that helps predict heart failure patients' chances of survival for up to five years and assists doctors in determining whether more or less aggressive treatment is appropriate.

Given that heart failure impacts more than 5 million Americans and numerous variables affect patient outcomes, this type of risk-assessment tool can be very helpful to physicians and patients in assessing prognosis over time and guiding medical decision-making, the researchers say.

Their new risk model is featured in the January edition of the journal Circulation: Heart Failure.

Since heart failure manifests differently in men and women, the team initially sought to create a sex-specific risk model for greater accuracy, an approach that hadn't been taken before. But they discovered that separate risk models for men and women weren't necessary.

"We were extremely surprised that the same exact top predictors of risk were identical in both men and women," said senior author Dr. Tamara Horwich, an assistant professor of medicine in the cardiology division at the David Geffen School of Medicine at UCLA. "We ultimately only needed to create one unified heart failure risk model for both sexes."

Heart failure occurs when the heart can no longer pump enough blood to the body's other organs. Often, patients with heart failure have reduced left-ventricle ejection fraction, which indicates a lowered volume of blood being pumped out of this heart chamber with each beat of the heart.

In developing the risk calculator, the UCLA team used data from 2,255 heart failure patients, including 1,569 men and 686 women, who were referred to the AhmansonUCLA Cardiomyopathy Center between 2000 and 2011.

They collected 39 patient variables, including information like age, weight, medications, lab work and the results of diagnostic tests such as echocardiography the use of ultrasound to investigate the action of the heart.

The team assessed each variable in terms of predicting the following serious risks: mortality, the need for an urgent transplant, and the need for a mechanical pump known as a ventricular assist device. Using a complex statistical analysis, they determined that four of the 39 factors were predictive of these serious risks in both men and women and could predict survival over a five-year period.

The four variables included:

  • B-type natriuretic peptide level
    This peptide (BNP) is a substance secreted from the ventricles, or lower chambers of the heart, in response to changes in pressure. The level of BNP in the blood increases when heart failure symptoms worsen and decreases when the condition is more stable.

  • Peak oxygen consumption
    Peak oxygen consumption (PkVO2), the maximum rate of oxygen used during exercise, is tested when a patient is on a treadmill or bike. Levels of oxygen get lower as heart failure worsens.

  • New York Heart Association classification
    This classification places a patient in one of four categories depending on how limited they are during physical activity. The limitations are related to breathing, shortness of breath and angina chest pain.

  • Heart failure medications
    Patients may be taking a common heart failure medication an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB).

Although women had many characteristics that differed from men for instance, younger age at heart failure diagnosis, with higher ejection fraction and had less coronary artery disease, these four key variables still proved the best in assessing risk in both sexes.

To develop the risk model, the researchers used data from patients referred to UCLA from 2000 to 2007. They then tested and validated its use with information on patients seen from 2008 to 2011.

"The model was just as effective in predicting risk in early as well as later years, when newer heart-failure treatments had emerged," said first author Jennifer Chyu, a UCLA student researcher at the time of the study who is now at the University of Washington.

According to Horwich, the risk calculator can currently be used via an Excel spreadsheet. The team also is actively working on developing a phone app of the calculator that will be even simpler; a doctor could simply enter in the four facts about a patient and the model would instantly calculate the annual survival risk up to five years.

"Physicians can begin to use the new UCLA tool right away for their advanced heart failure patients, to calculate survival risk," said study author Dr. Gregg C. Fonarow, UCLA's Eliot Corday Professor of Cardiovascular Medicine and Science and director of the AhmansonUCLA Cardiomyopathy Center.

For example, Fonarow said, patients at very high risk based on the calculator might consider very aggressive therapies such as a heart transplant or the surgical implantation of a heart assist device. Patients at lower risk may be able to avoid excess treatment.

The new UCLA risk calculator also performed better when tested against several other risk-prediction models, including the Seattle Heart Failure Model and the Heart Failure Survival Score.

The next step, according to Horwich, is testing the accuracy and utility of the UCLA model in a larger sample of patients.


'/>"/>

Contact: Rachel Champeau
rchampeau@mednet.ucla.edu
310-794-2270
University of California - Los Angeles Health Sciences
Source:Eurekalert

Related medicine news :

1. NIH awards $20 million over 5 years to train next generation of global health researchers
2. Researchers develop a new cell and animal model of inflammatory breast cancer
3. Researchers uncover a viable way for colorectal cancer patients to overcome drug resistance
4. Researchers Find Gene Mutations That May Be a Key to Autism
5. Researchers find evidence of banned antibiotics in poultry products
6. NJ stroke researchers report advances in spatial neglect research at AAN Conference
7. Autism by the numbers: Yale researchers examine impact of new diagnostic criteria
8. Researchers Map Brain Regions Linked to Intelligence
9. Researchers ID Genes That May Determine Mental Illness
10. Researchers Develop Blood Test for Depression
11. University of Cincinnati researchers win $3.7M grant from US Department of Defense
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... March 24, 2017 , ... Gastro Health ... partnership to prep patients for colonoscopy at the HyGIeaCare® Center that is to ... Miami, FL. , The HyGIeaCare® Prep, cleared by the U.S. Food ...
(Date:3/24/2017)... ... 2017 , ... “Finding Christ Through Social Media: Year One ... the writer’s path toward true communion with God. “Finding Christ Through Social Media: ... creation of published author Lea Michelle Johnson, a follower of Christ, wife and ...
(Date:3/24/2017)... ... March 24, 2017 , ... “The Communion of ... people of God in congregations across the United States. “The Communion of ... in 1964 who has served congregations in seven states throughout his long career ...
(Date:3/23/2017)... ... 23, 2017 , ... A recent report from the National Council on Teacher ... NCTQ report suggests, based on a review of GPA and SAT/ACT requirements at 221 ... the U.S. It argues that this higher bar should be set by states, by ...
(Date:3/23/2017)... ... March 23, 2017 , ... Texas Physical Therapy Specialists (TexPTS) ... Road in Building 2. The clinic is the group’s second in New Braunfels and ... the company’s second New Braunfels location brings things full circle for the group, “It’s ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... -- Research and Markets has announced the addition of ... report to their offering. ... The report provides separate comprehensive analytics for the US, Canada ... Asia-Pacific , Latin America , and ... 2015 through 2022. Also, a six-year historic analysis is provided for these ...
(Date:3/24/2017)... , March 24, 2017  Eli Lilly ... announced plans to invest $850 million in its ... facilities across its U.S. enterprise, including research laboratories, ... investments are being driven by demand for Lilly ... potential medicines in development targeting cancer, pain, diabetes ...
(Date:3/24/2017)... , March 23, 2017  Mirabilis Medical, ... advanced medical technology for non-invasive surgery, announced today ... System for treatment of uterine fibroids throughout the ... had received approval from the US Food and ... the Mirabilis System in the United States.  The ...
Breaking Medicine Technology: