Comparison of the Seattle Heart Failure Model and Cardiopulmonary Exercise Capacity for Prediction of Death in Patients With Chronic Ischemic Heart Failure and Intracoronary Progenitor Cell Application

Honold, Joerg; Rosa, Salvatore De; Spyridopoulos, Ioakim; Fischer‐Rasokat, Ulrich; Seeger, Florian; Leistner, David M.; Lotz, Saskia; Levy, Wayne C.; Zeiher, Andreas M.; Aßmus, Birgit

doi:10.1002/clc.22093

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…15 Median follow-up was 1673 days, interquartile range (IQR) [923,1828]. The primary endpoint was defined as allcause mortality and was confirmed by reviewing death certificates or contacting relatives or family physicians as previously described.…”

Section: Follow-up and Clinical Characteristicsmentioning

confidence: 99%

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Bone marrow and plasma FGF‐23 in heart failure patients: novel insights into the heart–bone axis

et al. 2019

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Aims Fibroblast growth factor 23 (FGF‐23) is known to be elevated in patients with congestive heart failure (CHF). As FGF‐23 is expressed in the bone but can also be expressed in the myocardium, the origin of serum FGF‐23 in CHF remains unclear. It is also unclear if FGF‐23 expressed in the bone is associated with outcome in CHF. The aim of the present study was to investigate FGF‐23 levels measured in bone marrow plasma (FGF‐23‐BM) and in peripheral blood (FGF‐23‐P) in CHF patients to gain further insights into the heart–bone axis of FGF‐23 expression. We also investigated possible associations between FGF‐23‐BM as well as FGF‐23‐P and outcome in CHF patients. Methods and results We determined FGF‐23‐P and FGF‐23‐BM levels in 203 CHF patients (85% male, mean age 61.3 years) with a left ventricular ejection fraction (LVEF) ≤45% and compared them with those of 48 healthy controls (48% male, mean age 39.2 years). We investigated the association between FGF‐23‐BM and FGF‐23‐P with all‐cause mortality in CHF patients, 32 events, median follow‐up 1673 days, interquartile range [923, 1828]. FGF‐23‐P (median 60.3 vs. 22.0 RU/mL, P < 0.001) and FGF‐23‐BM (median 130.7 vs. 93.1 RU/mL, P < 0.001) levels were higher in CHF patients compared with healthy controls. FGF‐23‐BM levels were significantly higher than FGF‐23‐P levels in both CHF patients and in healthy controls ( P < 0.001). FGF‐23‐P and FGF‐23‐BM correlated significantly with LVEF ( r = −0.37 and r = −0.33, respectively), N terminal pro brain natriuretic peptide levels ( r = 0.57 and r = 0.6, respectively), New York Heart Association status ( r = 0.28 and r = 0.25, respectively), and estimated glomerular filtration rate ( r = −0.43 and r = −0.41, respectively) ( P for all <0.001) and were independently associated with all‐cause mortality in CHF patients after adjustment for LVEF, estimated glomerular filtration rate, New York Heart Association status, and N terminal pro brain natriuretic peptide, hazard ratio 2.71 [confidence interval: 1.18–6.20], P = 0.018, and hazard ratio 2.80 [confidence interval: 1.19–6.57], P = 0.018, respectively. Conclusions In CHF patients, FGF‐23 is elevated in bone marrow plasma and is independently associated with heart failure severity and all‐cause mortality. The failing heart seems to interact via FGF‐23 within a heart–bone axis.

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Section: Follow-up and Clinical Characteristicsmentioning

confidence: 99%

“…The primary endpoint was defined as allcause mortality and was confirmed by reviewing death certificates or contacting relatives or family physicians as previously described. 15 Median follow-up was 1673 days, interquartile range (IQR) [923,1828].…”

Section: Follow-up and Clinical Characteristicsmentioning

confidence: 99%

Bone marrow and plasma FGF‐23 in heart failure patients: novel insights into the heart–bone axis

et al. 2019

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“…In line with these results, a very recent report including 2331 patients demonstrated that ICD use was associated with a 37% reduction in all‐cause mortality ( P = 0.002) after adjustment for the clinical risk profile, performed by means of the Seattle Heart Failure Model (SHFM) . The SHFM is a comprehensive scoring system, developed and validated in large HF patient datasets, which has excellent prognostic efficacy and the ability to differentiate among various modes of death . The SHFM has been shown to predict all‐cause mortality.…”

Section: Fundingmentioning

confidence: 71%

Should we rethink the indications for implantable cardioverter‐defibrillators in non‐ischaemic dilated cardiomyopathy?

Curcio

Rosa

Indolfi

2017

European J of Heart Fail

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Heart failure (HF) represents a major cause of morbidity and health care expenditure globally, 1 and increases the risk for sudden cardiac death (SCD). In the USA, about 325 000 adults die from SCD every year, accounting for half of all cardiovascular deaths. 2 The implantable cardioverter-defibrillator (ICD) is currently indicated for primary SCD prophylaxis in patients with severe left ventricular systolic dysfunction, irrespective of the underlying aetiology. 3,4 The recent results of the Danish Study to Assess the Efficacy of ICDs in Patients with Non-Ischaemic Systolic Heart Failure on Mortality (DANISH) 5 raised novel interest in the longstanding debate on the efficacy of ICD implantation in non-ischaemic dilated cardiomyopathy (NIDCM). In fact, the DANISH study found only a slightly lower, non-statistically significant (P = 0.28) reduction in the primary endpoint of all-cause mortality in NIDCM patients randomized to ICD implantation (21.6%) compared with the control group (23.4%) treated with optimal medical management but no ICD implantation over a median follow-up of 67.6 months ( Figure 1A). These results add further evidence to the findings of previous studies with conflicting results, such as the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) 6 and the Defibrillators in Non-Ischaemic Cardiomyopathy Treatment Evaluation (DEFINITE) study. 7 In order to resolve this still debated issue, in-depth analyses of these studies are required to disentangle the reasons underlying the differences observed across the results of individual studies. In fact, although the authors of the DANISH study concluded that ICD implantation is not associated with an overall survival benefit in patients with NIDCM, 5 perusal of the secondary endpoints shows that the frequency of SCD was almost halved in the ICD arm (4.3% vs. 8.2%; P = 0.005) ( Figure 1B). This latter finding raises doubts about the current strategy of defibrillator implantation for the primary prevention of SCD. In fact, although not statistically significant, hazard ratios (HRs) for all-cause death and cardiovascular death were 0.87 and 0.77, respectively, both in favour of ICD implantation. 5 However, the benefits to be gained from ICD use should be weighed against the risks for complications and side effects. Moreover, the differential impact of ICD on different modes of death should also be taken into account in studies evaluating ICD effectiveness. 8 In fact, a comprehensive evaluation of all key elements in play represents the best strategy for identifying predictors of success and failure of ICD therapy. Additionally, the results of the DANISH study 5 highlight the importance of stratifying patients according to level of risk. A subgroup analysis in the DANISH study revealed a significant reduction of the primary endpoint in specific patient categories, such as in younger patients (<59 years; P = 0.02) and in those with less severe HF (NT-proBNP <1177 pg/mL; P = 0.02), 5 although it should be noted that these results do not provide sufficient evi...

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“…In heart failure patients, prognostic models like the Seattle Heart Failure Model (SHFM) and the Meta‐Analysis Global Group in Chronic (MAGGIC) Heart Failure score are widely used [13] , [14] , [15] , [16] . However, only limited data exist about the prognostic accuracy of these scores in patients referred for TMVR [17] .…”

Section: Introductionmentioning

confidence: 99%

Differential prognostic accuracy of right ventricular dysfunction, the Seattle heart failure model and the MAGGIC score in patients with severe mitral regurgitation undergoing the MitraClip® procedure

Heyl

Luu

Wieszner

et al. 2020

IJC Heart & Vasculature

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Background MitraClip ® (MC) is an established procedure for severe mitral regurgitation (MR) in patients deemed unsuitable for surgery. Right ventricular dysfunction (RVD) is associated with a higher mortality risk. The prognostic accuracy of heart failure risk scores like the Seattle heart failure model (SHFM) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in pts undergoing MC with or without RVD has not been investigated so far. Methods SHFM and MAGGIC score were calculated retrospectively. RVD was determined as tricuspid annular plane systolic excursion (TAPSE) ≤15 mm. Area under receiver operating curves (AUROC) of SHFM and MAGGIC were performed for one-year all-cause mortality after MC. Results N = 103 pts with MR III° (73 ± 11 years, LVEF 37 ± 17%) underwent MC with a reduction of at least I° MR. One-year mortality was 28.2%. In Kaplan-Meier analysis, one- year mortality was significantly higher in RVD-pts (34.8% vs 2.8%, p = 0.009). Area under the Receiver Operating Characteristic (AUROC) for SHFM and MAGGIC were comparable for both scores (SHFM: 0.704, MAGGIC: 0.692). In pts without RVD, SHFM displayed a higher AUROC and therefore better diagnostic accuracy (SHFM: 0.776; MAGGIC: 0.551, p < 0.05). In pts with RVD, MAGGIC and SHFM displayed comparable AUROCs. Conclusion RVD is an important prognostic marker in pts undergoing MC. SHFM and MAGGIC displayed adequate over-all prognostic power in these pts. Accuracy differed in pts with and without RVD, indicating higher predictive power of the SHFM score in pts without RVD.

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Comparison of the Seattle Heart Failure Model and Cardiopulmonary Exercise Capacity for Prediction of Death in Patients With Chronic Ischemic Heart Failure and Intracoronary Progenitor Cell Application

Cited by 7 publications

References 26 publications

Bone marrow and plasma FGF‐23 in heart failure patients: novel insights into the heart–bone axis

Bone marrow and plasma FGF‐23 in heart failure patients: novel insights into the heart–bone axis

Should we rethink the indications for implantable cardioverter‐defibrillators in non‐ischaemic dilated cardiomyopathy?

Differential prognostic accuracy of right ventricular dysfunction, the Seattle heart failure model and the MAGGIC score in patients with severe mitral regurgitation undergoing the MitraClip® procedure

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