Please use this identifier to cite or link to this item: https://repositorio.usj.es/handle/123456789/297

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dc.contributor.authorRamírez, Julia-
dc.contributor.authorOrini, Michele-
dc.contributor.authorMincholé, Ana-
dc.contributor.authorMonasterio, Violeta-
dc.contributor.authorCygankiewicz, Iwona-
dc.contributor.authorde Luna, Antonio Bayeas-
dc.contributor.authorMartinez, Juan Pablo-
dc.contributor.authorLaguna, Pablo-
dc.contributor.authorPueyo, Esther-
dc.date.accessioned2020-01-15T14:32:14Z-
dc.date.available2020-01-15T14:32:14Z-
dc.date.issued2017-10-11-
dc.identifier.citationRamírez J, Orini M, Mincholé A, Monasterio V, Cygankiewicz I, Bayés de Luna A, et al. (2017) Sudden cardiac death and pump failure death prediction in chronic heart failure by combining ECG and clinical markers in an integrated risk model. PLoS ONE 12(10): e0186152. https://doi.org/10.1371/journal.pone.0186152es_ES
dc.identifier.issn1932-6203es_ES
dc.identifier.urihttps://repositorio.usj.es/handle/123456789/297-
dc.description.abstractBackground 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 Subita 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 (Delta alpha(Tpe)) 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, Delta alpha(Tpe) and TMR. For PFD, the indices were diabetes, NYHA class, Delta alpha(Tpe) 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.es_ES
dc.format.extent15 p.es_ES
dc.format.mimetypeapplication/pdfes_ES
dc.language.isoenges_ES
dc.publisherPUBLIC LIBRARY SCIENCE, 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USAes_ES
dc.relationThis work was supported by projects TIN2013-41998-R to EP, PL, and JR, and DPI2016-75458-R to JPM, EP, and PL from the Spanish Ministry of Economy and Competitiveness (MINEGO), Spain, the MULTITOOLS2HEART from GIBER-BBN through Institute de Salud Carlos III, Spain to JPM, EP, and PL, the European Social Fund (EU) and Aragon Government through BSICoS group (T96) to JPM, EP, and PL, and by the European Research Council (ERC) through project ERC-2014-StG 638284 to EP.es_ES
dc.relation.requiresAdobe PDFes_ES
dc.rightsAtribución 4.0 Internacional*
dc.rightsAtribución 4.0 Internacional*
dc.rightsAtribución 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectT- Wave alternanses_ES
dc.subjectRate turbulencees_ES
dc.subjectPostinfarction patientses_ES
dc.subjectMortalityes_ES
dc.subjectRepolarizationes_ES
dc.subjectEpidemologyes_ES
dc.subjectRestitutiones_ES
dc.subjectDispersiones_ES
dc.subjectTherapyes_ES
dc.subjectStratificationes_ES
dc.titleSudden cardiac death and pump failure death prediction in chronic heart failure by combining ECG and clinical markers in an integrated risk modeles_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.subject.unescoPacientees_ES
dc.relation.publisherversionhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186152es_ES
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0186152es_ES
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesses_ES
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