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MAGGIC风险模型可预测非缺血性扩张型心肌病的不良事件及左心室重构。

MAGGIC Risk Model Predicts Adverse Events and Left Ventricular Remodeling in Non-Ischemic Dilated Cardiomyopathy.

作者信息

Dong Yang, Wang Dongfei, Lv Jialan, Pan Zhicheng, Xu Rui, Ding Jie, Cui Xiao, Xie Xudong, Guo Xiaogang

机构信息

Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

出版信息

Int J Gen Med. 2020 Dec 10;13:1477-1486. doi: 10.2147/IJGM.S288732. eCollection 2020.

Abstract

PURPOSE

We aimed to study the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) risk model's prognostic value and relationship with left ventricular remodeling in dilated cardiomyopathy.

PATIENTS AND METHODS

Dilated cardiomyopathy patients were prospectively recruited and underwent clinical assessments. MAGGIC risk score was calculated. Patients were followed up for adverse events and echocardiography. Primary endpoints were all-cause mortality and first rehospitalization due to heart failure. Secondary endpoint was left ventricular remodeling defined as a decline in left ventricular ejection fraction >10% or an increase in left ventricular end-diastolic diameter >10%. Survival status was examined using Cox regression analysis. The model's ability to discriminate adverse events and left ventricular remodeling was calculated using a receiver operating characteristics curve.

RESULTS

In total, 114 patients were included (median follow-up time = 31 months). The risk score was independently related to adverse events (2-year all-cause mortality: hazard ratio [HR] = 1.122; 95% confidence interval [CI], 1.043-1.208; 1-year first rehospitalization due to heart failure: HR = 1.094; 95% CI, 1.032-1.158; 2-year first rehospitalization due to heart failure: HR = 1.088; 95% CI, 1.033-1.147, all P < 0.05). One-year change in left ventricular end-diastolic diameter was correlated with the risk score (r = 0.305, P = 0.002). The model demonstrated modest ability in discriminating adverse events and left ventricular remodeling (all areas under the curve were 0.6-0.7).

CONCLUSION

The MAGGIC risk score was related to adverse events and left ventricular remodeling in dilated cardiomyopathy.

摘要

目的

我们旨在研究慢性心力衰竭Meta分析全球组(MAGGIC)风险模型在扩张型心肌病中的预后价值及其与左心室重构的关系。

患者与方法

前瞻性招募扩张型心肌病患者并进行临床评估。计算MAGGIC风险评分。对患者进行不良事件和超声心动图随访。主要终点为全因死亡率和首次因心力衰竭再次住院。次要终点为左心室重构,定义为左心室射血分数下降>10%或左心室舒张末期内径增加>10%。使用Cox回归分析检查生存状态。使用受试者工作特征曲线计算该模型区分不良事件和左心室重构的能力。

结果

共纳入114例患者(中位随访时间=31个月)。风险评分与不良事件独立相关(2年全因死亡率:风险比[HR]=1.122;95%置信区间[CI],1.043 - 1.208;1年首次因心力衰竭再次住院:HR = 1.094;95% CI,1.032 - 1.158;2年首次因心力衰竭再次住院:HR = 1.088;95% CI,1.033 - 1.147,均P < 0.05)。左心室舒张末期内径的1年变化与风险评分相关(r = 0.305,P = 0.002)。该模型在区分不良事件和左心室重构方面表现出中等能力(曲线下面积均为0.6 - 0.7)。

结论

MAGGIC风险评分与扩张型心肌病的不良事件和左心室重构相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6fd/7736706/adbc5d028bd2/IJGM-13-1477-g0001.jpg

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