A Risk Prediction Model for Mortality in Patients with Dilated Cardiomyopathy

Abstract

The aim of this study was to build a risk prediction model for 1-year mortality on the bases of clinical and functional indicators in patients with dilated cardiomyopathy (DCM). Materials and Methods: The study included 205 patients (aged from 16 to 61 years) with DCM and chronic heart failure in NYHA FC II-IV. The study included the collection of anamnestic data, physical examinations, clinical and biochemical laboratory methods, 12-lead ECG, echocardiography, and Holter ECG monitoring , 6-minute walk test. The duration of follow-up was 3 to 170 months (36.7±5.6). The study end-points were death (sudden death or progression of heart failure) and thromboembolic complications (pulmonary embolism, ischemic stroke, thromboembolism of the vessels of kidneys and lower extremities). Results: A sequential evaluation of clinical-anamnestic and instrumental data with analysis of the life expectancy and the subsequent construction of a risk prediction model for 1-year mortality by the method of multiple stepwise logistic regression was performed. In accordance with the results of multiple regression analysis, among the clinico-functional parameters, NYHA class III/IV, low blood pressure, a relatively young age, abnormal QRS complex, high-grade ventricular arrhythmias and an increase in LVESV/LVEDV ratio (>0.66) are the most influencing factors for a fatal outcome within 1 year of observation.

Keywords

• dilated cardiomyopathy
• risk stratification
• life expectancy
• prognosis