000069680 001__ 69680
000069680 005__ 20210507081945.0
000069680 0247_ $$2doi$$a10.1371/journal.pone.0186152
000069680 0248_ $$2sideral$$a101484
000069680 037__ $$aART-2017-101484
000069680 041__ $$aeng
000069680 100__ $$0(orcid)0000-0003-4130-5866$$aRamirez García, Julia$$uUniversidad de Zaragoza
000069680 245__ $$aSudden cardiac death and pump failure death prediction in chronic heart failure by combining ECG and clinical markers in an integrated risk model
000069680 260__ $$c2017
000069680 5060_ $$aAccess copy available to the general public$$fUnrestricted
000069680 5203_ $$aBackground: Sudden cardiac death (SCD) and pump failure death (PFD) are common endpoints in chronic heart failure (CHF) patients, but prevention strategies are different. Currently used tools to specifically predict these endpoints are limited. We developed risk models to specifically assess SCD and PFD risk in CHF by combining ECG markers and clinical variables.
Methods: The relation of clinical and ECG markers with SCD and PFD risk was assessed in 597 patients enrolled in the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study. ECG indices included: turbulence slope (TS), reflecting autonomic dysfunction; T-wave alternans (TWA), reflecting ventricular repolarization instability; and T-peak-to-end restitution (¿aTpe) and T-wave morphology restitution (TMR), both reflecting changes in dispersion of repolarization due to heart rate changes. Standard clinical indices were also included.
Results: The indices with the greatest SCD prognostic impact were gender, New York Heart Association (NYHA) class, left ventricular ejection fraction, TWA, ¿aTpe and TMR. For PFD, the indices were diabetes, NYHA class, ¿aTpe and TS. Using a model with only clinical variables, the hazard ratios (HRs) for SCD and PFD for patients in the high-risk group (fifth quintile of risk score) with respect to patients in the low-risk group (first and second quintiles of risk score) were both greater than 4. HRs for SCD and PFD increased to 9 and 11 when using a model including only ECG markers, and to 14 and 13, when combining clinical and ECG markers.
Conclusion: The inclusion of ECG markers capturing complementary pro-arrhythmic and pump failure mechanisms into risk models based only on standard clinical variables substantially improves prediction of SCD and PFD in CHF patients.
000069680 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/DPI2016-75458-R$$9This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 638284-MODELAGE$$9info:eu-repo/grantAgreement/EC/H2020/638284/EU/Is your heart aging well? A systems biology approach to characterize cardiac aging from the cell to the body surface/MODELAGE$$9info:eu-repo/grantAgreement/ES/DGA/T96$$9info:eu-repo/grantAgreement/ES/MINECO/TIN2013-41998-R
000069680 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000069680 590__ $$a2.766$$b2017
000069680 591__ $$aMULTIDISCIPLINARY SCIENCES$$b15 / 64 = 0.234$$c2017$$dQ1$$eT1
000069680 592__ $$a1.164$$b2017
000069680 593__ $$aAgricultural and Biological Sciences (miscellaneous)$$c2017$$dQ1
000069680 593__ $$aMedicine (miscellaneous)$$c2017$$dQ1
000069680 593__ $$aBiochemistry, Genetics and Molecular Biology (miscellaneous)$$c2017$$dQ1
000069680 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000069680 700__ $$aOrini, Michele
000069680 700__ $$aMinchole, Ana
000069680 700__ $$0(orcid)0000-0001-5343-5671$$aMonasterio, Violeta
000069680 700__ $$aCygankiewicz, Iwona
000069680 700__ $$aBayes de Luna, Antonio
000069680 700__ $$0(orcid)0000-0002-7503-3339$$aMartinez, Juan Pablo$$uUniversidad de Zaragoza
000069680 700__ $$0(orcid)0000-0002-1960-407X$$aLaguna, Pablo$$uUniversidad de Zaragoza
000069680 700__ $$0(orcid)0000-0003-3434-9254$$aPueyo, Esther$$uUniversidad de Zaragoza
000069680 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000069680 773__ $$g12, 10 (2017), e0186152 [15 pp.]$$pPLoS One$$tPloS one$$x1932-6203
000069680 8564_ $$s2393545$$uhttps://zaguan.unizar.es/record/69680/files/texto_completo.pdf$$yVersión publicada
000069680 8564_ $$s102194$$uhttps://zaguan.unizar.es/record/69680/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000069680 909CO $$ooai:zaguan.unizar.es:69680$$particulos$$pdriver
000069680 951__ $$a2021-05-07-08:10:07
000069680 980__ $$aARTICLE