Background: Accurately assessing the postoperative mortality and rehospitalization for heart failure risks in patients undergoing mitral valve repair surgery is of significant importance for individualized medical strategies.
Objective: We sought to develop and validate a risk assessment system for the prediction of mortality and rehospitalization for heart failure.
Methods: Personalized risk prediction system of mortality and rehospitalization for heart failure was developed. For developing a prediction system with death as the outcome, there were 965 patients (70%) and 413 patients (30%) were included in the the derivation cohort and the validation cohort. For developing a prediction system with rehospitalization for heart failure as the outcome, there were 927 patients (70%) and 398 patients (30%) were included in the derivation cohort and the validation cohort. There were 42 routine clinical variables used to develop the models. The performance evaluation of the model is based on the area under the curve (AUC). Evaluate the improvement with Euro Score II according to NRI and IDI net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Results: The median follow-up time was 685 days, the incidence of death was 3.85% ( = 53), and the incidence of rehospitalization for heart failure was 10.01% ( = 138). The AUC values of the mortality prediction model in the derivation and validation cohorts were 0.825 (0.764-0.886) and 0.808 (0.699-0.917), respectively. The AUC values of the rehospitalization for heart failure prediction model in the derivation and validation cohorts were 0.794 (0.756-0.832) and 0.812 (0.758-0.866), respectively. NRI and IDI showed that the mortality prediction model exhibited superior performance than the Euro Score II. The mortality and rehospitalization for heart failure risk prediction models effectively stratified patients into different risk subgroups.
Conclusion: The developed and validated models exhibit satisfactory performance in prediction of all-cause mortality and rehospitalization for heart failure after mitral valve repair surgery.
Clinical Trial Registration: http://www.clinicaltrials.gov, Unique identifier: (NCT05141292).
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http://dx.doi.org/10.3389/fcvm.2024.1470987 | DOI Listing |
J Clin Med
January 2025
National Center for Global Health, Istituto Superiore di Sanitá, 00161 Rome, Italy.
Paravalvular leak (PVL) was initially recognized as one of the most common complications after transcatheter aortic valve implantation (TAVI) and has been linked to adverse clinical outcomes, including mortality. This study aims to assess the long-term clinical effects of PVL in patients undergoing TAVI with the latest generation of transcatheter aortic valves, as part of the national observational prospective multicenter study OBSERVANT II. OBSERVANT II included all consecutive patients with severe aortic stenosis who underwent TAVI across 28 Italian centers from December 2016 to September 2018.
View Article and Find Full Text PDFJ Clin Med
January 2025
Division of Internal Medicine, IRCCS MultiMedica, 20123 Milan, Italy.
During the last few years, significant pathophysiological differences between heart failure (HF) patients with "normal" ejection fraction (EF) (50% to 64%) and those with supra-normal EF (≥65%) have been highlighted. However, these distinct EF phenotypes have been poorly investigated in elderly patients aged ≥70 y. Accordingly, the present study aimed at assessing the clinical and echocardiographic characteristics of a retrospective cohort of elderly HFpEF patients (aged ≥ 70 y), categorized on the basis of "normal" EF (50 to 64%) or "supra-normal" EF (≥65%).
View Article and Find Full Text PDFBiomedicines
January 2025
Department Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Introduction And Aim: Assessing decongestion in patients with acute decompensated heart failure (ADHF) is challenging, requiring multiple parameters and often remaining imprecise. The study aimed to investigate the utility of indirectly estimating plasma variation (∆ePVS) for evaluating decongestion in ADHF patients in relation to natriuretic peptides.
Materials And Methods: This prospective, observational, single-center study included 111 patients (mean age 74 years, 40% female) hospitalized with ADHF and treated with intravenous diuretics along with optimized medical therapy.
J Card Fail
January 2025
Columbia University Irving Medical Center, New York, NY. Electronic address:
Background: The benefit of implantable cardioverter-defibrillators (ICD) and cardiovascular resynchronization therapy (CRT-D) in patients supported with a HeartMate 3 left ventricular assist device (LVAD) remains uncertain.
Methods: An analysis of the MOMENTUM 3 randomized clinical trial and the first 1000 patients in the Continued Access Protocol trial. Patients were divided into three groups based on the presence of ICD and/or CRT-D: No device (n=153, 11%), ICD only (n=699, 50.
Am J Cardiol
January 2025
Health Sciences University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Division of Cardiology. Electronic address:
Congestive symptoms are the primary cause of hospitalizations in heart failure (HF), and diuretics remain the cornerstone of their management. However, clinical practice varies widely due to a lack of a reliable measure of congestion guiding diuretic use. Consequently, many HF patients are discharged prematurely without adequate decongestion, leading to increased readmissions and mortality.
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