Erdogan Güney, Yenerçağ Mustafa, Uçar Melisa, Öztürk Onur, Şeker Onur Osman, Yontar Osman Can, Çakmak Ender Özgün, Karagöz Ali, Şahin İrfan, Arslan Uğur
University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun, Türkiye.
Ordu University, Training and Research Hospital, Cardiology Clinic, Ordu, Türkiye.
Turk Kardiyol Dern Ars. 2023 Mar;51(2):104-111. doi: 10.5543/tkda.2022.99448.
Whether modified Glasgow prognostic score predicts prognosis in patients with cardiac resynchronization therapy with defibrillation is unknown. Our aim was to investigate the association of modified Glasgow prognostic score with death and hospitalization in cardiac resynchronization therapy with defibrillation patients.
A total of 306 heart failure with reduced ejection fraction patients who underwent cardiac resynchronization therapy with defibrillation implantation were categorized into 3 groups based on their modified Glasgow prognostic score categorical levels. C-reactive protein >10 mg/L or albumin <35 g/L was assigned 1 point each and the patients were classified into 0, 1, and 2 points, respectively. Remodeling was determined according to the clinical event and myocardial remodeling criteria. Major adverse cardiac events were defined as mortality and/or hospitalization for heart failure.
Age, New York Heart Association functional class, modified Glasgow prognostic score prior to cardiac resynchronization therapy with defibrillation, sodium levels, and left atrial diameter were higher in the major adverse cardiac events(+) group. Age, left atrial diameter, and higher modified Glasgow prognostic score were found to be predictors of heart failure hospitalization/death in multivariable penalized Cox regression analysis. Besides, patients with lower modified Glasgow prognostic score showed better reverse left ventricular remodeling demonstrated by increase in left ventricle ejection fraction and decline in left ventricle end systolic volume.
Modified Glasgow prognostic score prior to cardiac resynchronization therapy with defibrillation can be used as a predictor of long-term heart failure hospitalization and death in addition to age and left atrial diameter. These results can guide the patient selection for cardiac resynchronization therapy with defibrillation therapy and highlight the importance of nutritional status.
改良格拉斯哥预后评分能否预测接受心脏再同步化治疗除颤患者的预后尚不清楚。我们的目的是研究改良格拉斯哥预后评分与接受心脏再同步化治疗除颤患者的死亡和住院之间的关联。
总共306例接受心脏再同步化治疗除颤植入的射血分数降低的心力衰竭患者，根据其改良格拉斯哥预后评分分类水平分为3组。C反应蛋白>10mg/L或白蛋白<35g/L各计1分，患者分别分为0分、1分和2分。根据临床事件和心肌重塑标准确定重塑情况。主要不良心脏事件定义为死亡和/或因心力衰竭住院。
主要不良心脏事件（+）组的年龄、纽约心脏协会功能分级、心脏再同步化治疗除颤前的改良格拉斯哥预后评分、钠水平和左心房直径更高。在多变量惩罚Cox回归分析中，年龄、左心房直径和更高的改良格拉斯哥预后评分被发现是心力衰竭住院/死亡的预测因素。此外，改良格拉斯哥预后评分较低的患者表现出更好的左心室逆向重塑，表现为左心室射血分数增加和左心室收缩末期容积下降。
心脏再同步化治疗除颤前的改良格拉斯哥预后评分除年龄和左心房直径外，还可作为长期心力衰竭住院和死亡的预测指标。这些结果可为心脏再同步化治疗除颤的患者选择提供指导，并突出营养状况的重要性。
