2016


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2016/№2

The place of non-routine HF-lEF in evaluation of one-year survival: where does the road go from “available prognosis”?

Prokopova L. V., Sitnikova M. Yu., Dorofeykov V. V., Lelyavina T. A., Kashuba S. M.
Federal State Budgetary Institution, “V. A. Almazov Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: prognosis, systolic heart failure, high-tech methods of health care, one-year survival, biomarkers, pathophysiological process

DOI: 10.18087/rhfj.2016.2.2193

Background. The need for predicting survival of patients with HF with low EF (HF-lEF) to timely identify indications for using high-technology methods of treatment (HMT). Aim. To identify contribution of non-routine laboratory (NT-proBNP, myeloperoxidase (MPO), HS troponin, sST2) and instrumental (VO2 peak , VE / VCO2) predictors to one-year prognosis of HF-LV lEF in patients managed by HF specialists and to compare significance of these non-routine predictors with routine RFs. Materials and methods. A prospective study on 212 patients with FC II-IV HF-lEF and LV EF ≤35 % (Simpson) admitted to the Federal State Budgetary Institution, “V. A. Almazov Federal Medical Research Center” from 2011 through 2012. Results. The study confirmed a high predictive significance of increased serum levels of MPO (p=0.008), sST2 (p=0.018), NT-proBNP (p<0.001), and major parameters of the cardiorespiratory test (CRT) indicative of reduced exercise tolerance – low oxygen consumption at a peak load (VO2 peak) and high ventilatory equivalent for CO2 (VE / VCO2). Our study did not confirm a predictive significance of serum HS troponin (p=0.338). Conclusion. The base model for predicting a probability of HF-lEF outcome within 12 months, which was obtained during the “Available Prognosis” study and included HR, orthostatic SBP, age of CHF onset, and % RDW and lymphocytes in blood, was not inferior by efficiency to prognostic scales containing markers for tension of pathogenetic processes (serum levels of MPO, sST2, and NT-proBNP). In stabilized CHF, the parameter of blood HS troponin does not have a predictive significance.
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Prokopova L. V., Sitnikova M. Yu., Dorofeykov V. V., Lelyavina T. A., Kashuba S. M. The place of non-routine HF-lEF in evaluation of one-year survival: where does the road go from “available prognosis”? Russian Heart Failure Journal. 2016;17 (2):82–90

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