[Clinical and anamnestic predictors of poor long-term prognosis in patients with chronic heart failure and implanted cardioverter-defibrillator].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-02-21 DOI:10.26442/00403660.2025.01.203045

N B Lebedeva, I V Talibullin, P G Parfenov, O L Barbarash

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引用次数: 0

Abstract

Aim: Identification of a complex of clinical and anamnestic predictors of an unfavorable long-term prognosis in patients with heart failure with low left ventricular ejection fraction and an implanted cardioverter-defibrillator (ICD).

Materials and methods: In 260 patients with heart failure with low left ventricular ejection fraction and ICD included in the "Kuzbass Register of Patients with ICD", data were obtained on the status of alive/dead, causes of death and cardiovascular events during a 4-year follow-up period. The clinical-instrumental and socio-demographic parameters entered into the register before ICD implantation were used to compile a prognostic regression model.

Results: A total of 348 cardiovascular events (endpoints) were recorded, of which 54 were deaths. The main cause of death in 48 (88.9%) patients was acute decompensated heart failure. According to the multivariate regression analysis, the factors that increase the risk of an unfavorable long-term outcome included in the prognostic model were: the level of systolic pressure in the pulmonary artery, the thickness of the interventricular septum, social status, the presence of chronic obstructive pulmonary disease, the low ejection fraction of the left ventricle and the absence of a renin-blocker angiotensin-aldosterone system (model sensitivity - 70%, specificity - 75.9%, AUC=0.8).

Conclusion: The use of a predictive model in clinical practice will make it possible to personalize approaches to making a decision on the need for ICD implantation and further monitoring of patients in order to improve their survival.

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[慢性心力衰竭和植入心脏转复除颤器患者长期预后不良的临床和记忆预测因素]。

目的：确定低左室射血分数和植入心脏转复除颤器（ICD）的心力衰竭患者不良长期预后的临床和记忆预测因子的复合体。材料和方法：在“库兹巴斯ICD患者登记册”中纳入的260例左室射血分数低和ICD的心力衰竭患者中，在4年的随访期间获得了有关存活/死亡状态、死亡原因和心血管事件的数据。使用ICD植入前登记的临床仪器和社会人口学参数来编制预后回归模型。结果：共记录了348例心血管事件（终点），其中54例死亡。48例（88.9%）患者的主要死亡原因是急性失代偿性心力衰竭。根据多因素回归分析，预后模型中增加不良长期结局风险的因素有：肺动脉收缩压水平、室间隔厚度、社会地位、是否存在慢性阻塞性肺疾病、左心室射血分数低以及是否存在肾素阻滞剂血管紧张素-醛固酮系统（模型敏感性为70%，特异性为75.9%，AUC=0.8）。结论：在临床实践中使用预测模型将使个性化的方法来决定是否需要ICD植入和进一步监测患者，以提高患者的生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.