Original clinical scienceRisk assessment in pulmonary hypertension associated with heart failure and preserved ejection fraction
Section snippets
Data collection
The model derivation sample, the Pulmonary Hypertension Connection (PHC) registry, was initiated in March 2004 and consists of patients evaluated at a single practice at 3 university hospitals—University of Illinois, Rush University Medical Center, and University of Chicago, all Chicago, Illinois—between 1982 and 2009, as described in detail previously.10 Patients were entered retrospectively from 1982 to February 2004 and prospectively from March 2004 onward. The PHC registry is based on
Demographics
Mean age on entry into the study was 63 ± 14 years, and 79% of patients were female. Comorbid conditions were highly prevalent, including hypertension (67%), obesity (39%), and diabetes (33%). Ethnicity data was available in only 98 patients (29%), of whom 63% were white, 33% were black, 3% were Hispanic, and 0.3% were Asian. Owing to the lack of complete data, the prognostic utility of ethnicity could not be determined.
The PHC registry largely consisted of HFpEF patients, which comprised 90.0%
Discussion
In this study we created a prognostic risk score for PH-HFpEF. The validation of our risk score in 2 independent PH-HFpEF cohorts (including 1 prospective, systematic cohort of patients with HFpEF) with varying disease severity illustrates the importance and consistency of the components of our risk model. Our current risk model compares favorably with other well-known prognostic models in systolic heart failure and cardiac transplantation, with similar discriminatory power, as illustrated by
Disclosure statement
The authors thank those individuals who have seen patients at the PH center and those who helped with data entry, including Jill Russo, RN, APN, Thenappan Thenappan, MD, and Tobias Perrino. We also thank Dave P. Miller for his excellent guidance and statistical support.
Sanjiv J. Shah reports receiving research grants from the American Heart Association, the National Institutes of Health, Gilead Sciences, Actelion Pharmaceuticals, the American Society of Echocardiography, the Heart Failure
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