Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices

Aim. Based on clinical parameters and diagnostic investigations, to create a complex model of personalized selection of patients with heart failure (HF) for cardiac resynchronization therapy (CRT). To establish the diagnostic value of the created model in predicting 5-year survival.Material and meth...

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Main Authors: A. M. Soldatova, V. A. Kuznetsov, E. A. Gorbatenko, T. N. Enina, L. M. Malishevsky
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2021-07-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/4409
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author A. M. Soldatova
V. A. Kuznetsov
E. A. Gorbatenko
T. N. Enina
L. M. Malishevsky
author_facet A. M. Soldatova
V. A. Kuznetsov
E. A. Gorbatenko
T. N. Enina
L. M. Malishevsky
author_sort A. M. Soldatova
collection DOAJ
description Aim. Based on clinical parameters and diagnostic investigations, to create a complex model of personalized selection of patients with heart failure (HF) for cardiac resynchronization therapy (CRT). To establish the diagnostic value of the created model in predicting 5-year survival.Material and methods. The study included 141 patients with HF (men, 77,3%; women, 22,7%). The mean age of patients at the time of implantation was 60,0 [53,0; 66,0] years. All patients had New York Heart Association (NYHA) class II-IV HF, left ventricular ejection fraction (LVEF) ≤35%, and QRS ≥130 ms. Patients were randomly divided into training (n=95) and test (n=36) samples, which were comparable in main clinical and functional characteristics.Results. The index included parameters that had a significant relationship with 5-year survival according to the Cox regression: male sex, prior myocardial infarction, hypertension, QRS <150 ms, no left bundle branch block, PR ≥200 ms with sinus rhythm/absence of radiofrequency ablation in atrial fibrillation, NYHA class III, IV HF, LVEF <30%, left ventricular end-diastolic volume ≥235,0 ml, NT-proBNP ≥2692,0 ng/ml. All variables were scored based on the в-coefficients. In the training sample, a value ≥45 points demonstrated a sensitivity of 82,4% and a specificity of 67,2% in predicting 5-year survival (AUC, 0,873; p<0,001). The index use on the test sample showed comparable results (AUC, 0,718; p=0,020; sensitivity — 71,4%, specificity — 62,5%). Also, in the training sample, the index ≥45 points was associated with1-year survival (sensitivity — 84,6%, specificity — 58,1%, AUC, 0,811; p<0,001).Conclusion. An index of personalized selection for CRT has been created, which makes it possible to accurately predict the 5-year survival rate, as well as the 1-year survival rate, regardless of the current selection criteria.
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spelling doaj-art-e1bc5df3a183418b934e4ae4f3b1fc1d2025-08-20T02:59:04Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-07-0126610.15829/1560-4071-2021-44093233Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devicesA. M. Soldatova0V. A. Kuznetsov1E. A. Gorbatenko2T. N. Enina3L. M. Malishevsky4Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of SciencesTyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of SciencesTyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of SciencesTyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of SciencesTyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of SciencesAim. Based on clinical parameters and diagnostic investigations, to create a complex model of personalized selection of patients with heart failure (HF) for cardiac resynchronization therapy (CRT). To establish the diagnostic value of the created model in predicting 5-year survival.Material and methods. The study included 141 patients with HF (men, 77,3%; women, 22,7%). The mean age of patients at the time of implantation was 60,0 [53,0; 66,0] years. All patients had New York Heart Association (NYHA) class II-IV HF, left ventricular ejection fraction (LVEF) ≤35%, and QRS ≥130 ms. Patients were randomly divided into training (n=95) and test (n=36) samples, which were comparable in main clinical and functional characteristics.Results. The index included parameters that had a significant relationship with 5-year survival according to the Cox regression: male sex, prior myocardial infarction, hypertension, QRS <150 ms, no left bundle branch block, PR ≥200 ms with sinus rhythm/absence of radiofrequency ablation in atrial fibrillation, NYHA class III, IV HF, LVEF <30%, left ventricular end-diastolic volume ≥235,0 ml, NT-proBNP ≥2692,0 ng/ml. All variables were scored based on the в-coefficients. In the training sample, a value ≥45 points demonstrated a sensitivity of 82,4% and a specificity of 67,2% in predicting 5-year survival (AUC, 0,873; p<0,001). The index use on the test sample showed comparable results (AUC, 0,718; p=0,020; sensitivity — 71,4%, specificity — 62,5%). Also, in the training sample, the index ≥45 points was associated with1-year survival (sensitivity — 84,6%, specificity — 58,1%, AUC, 0,811; p<0,001).Conclusion. An index of personalized selection for CRT has been created, which makes it possible to accurately predict the 5-year survival rate, as well as the 1-year survival rate, regardless of the current selection criteria.https://russjcardiol.elpub.ru/jour/article/view/4409cardiac resynchronization therapyheart failuresurvival
spellingShingle A. M. Soldatova
V. A. Kuznetsov
E. A. Gorbatenko
T. N. Enina
L. M. Malishevsky
Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
Российский кардиологический журнал
cardiac resynchronization therapy
heart failure
survival
title Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
title_full Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
title_fullStr Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
title_full_unstemmed Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
title_short Prediction of 5-year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
title_sort prediction of 5 year survival in patients with heart failure and implanted cardiac resynchronization therapy devices
topic cardiac resynchronization therapy
heart failure
survival
url https://russjcardiol.elpub.ru/jour/article/view/4409
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AT eagorbatenko predictionof5yearsurvivalinpatientswithheartfailureandimplantedcardiacresynchronizationtherapydevices
AT tnenina predictionof5yearsurvivalinpatientswithheartfailureandimplantedcardiacresynchronizationtherapydevices
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