| Predicting sudden death in patients with mild to moderate chronic heart failure. | |
| | |
MedLine Citation:
|
PMID: 15367507 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To explore the relation between non-invasive measures of cardiac function and sudden cardiac death, as well as the development and utility of an index integrating these variables to identify patients at increased risk of this mode of death. DESIGN: UK-HEART (United Kingdom-heart failure evaluation and assessment of risk trial) was a prospective study conducted between December 1993 and April 2000. The study was specifically designed to identify non-invasive markers of death and mode of death among patients with chronic heart failure. SETTING: 8 UK general hospitals. MAIN OUTCOME MEASURES: Death and mode of death. RESULTS: 553 patients aged a mean (SD) of 63 (10) years, in New York Heart Association functional class 2.3 (0.02), recruited prospectively. After 2365 patient-years' follow up, 201 patients had died (67 suddenly). Predictors of sudden death were greater cardiothoracic ratio, QRS dispersion, QT dispersion corrected for rate (QTc) across leads V1-V6 on the 12 lead ECG, and the presence of non-sustained ventricular tachycardia. The hazard ratio and 95% confidence intervals (CI) of sudden death for a 10% increase in cardiothoracic ratio was 1.43 (95% CI 1.20 to 1.71), for a 10% increase in QRS dispersion 1.11 (95% CI 1.04 to 1.19), for the presence of non-sustained ventricular tachycardia 2.03 (95% CI 1.27 to 3.25), and for a 10% increase in QTc dispersion across leads V1-V6 1.03 (95% CI 1.00 to 1.07) (all p < 0.04). An index derived from these four factors performed well in identifying patients specifically at increased risk of sudden death. CONCLUSIONS: Results show that an index derived from three widely available non-invasive investigations has the potential to identify ambulant patients with chronic heart failure at increased risk of sudden death. This predictive tool could be used to target more sophisticated investigations or interventions aimed at preventing sudden death. |
| | |
Authors:
|
M T Kearney; K A A Fox; A J Lee; W P Brooksby; A M Shah; A Flapan; R J Prescott; R Andrews; P D Batin; D L Eckberg; N Gall; A G Zaman; H S Lindsay; J Nolan |
Related Documents
:
|
1395187 - Cardiac pathology in 2007 consecutive forensic autopsies. 2680507 - Pathophysiological mechanisms of ventricular tachyarrhythmias. 16450807 - Epidemiology and stratification of risk for sudden cardiac death. 22402367 - Curcumin reduces the cardiac ischemia-reperfusion injury: involvement of the toll-like ... 8343327 - A patient in whom self-terminating ventricular fibrillation was a manifestation of myoc... 15954507 - Distribution of pleural effusion in congestive heart failure: what is atypical? |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Heart (British Cardiac Society) Volume: 90 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2004 Oct |
Date Detail:
|
Created Date: 2004-09-15 Completed Date: 2004-10-04 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
|
Languages: eng Pagination: 1137-43 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiology, King's College, Bessemer Road, London SE5 9PJ, UK. mark.kearney@kcl.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Cardiomegaly / complications, physiopathology Chronic Disease Death, Sudden / etiology* Electrocardiography Epidemiologic Methods Female Heart Failure / complications*, physiopathology Humans Male Middle Aged Tachycardia, Ventricular / complications, physiopathology |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: National survey of the prevalence, incidence, primary care burden, and treatment of heart failure in...
Next Document: Exercise capacity and cardiac function assessed by tissue Doppler imaging in chronic heart failure.