左室瘤に対する線状心室形成術後の患者死亡率予測のためのノモグラム
Xieraili Tiemuerniyazi1, Yangwu Song1, Liangcai Chen1
1Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background:
The long-term mortality of patients undergoing linear ventriculoplasty (LVP) for ischaemic left ventricular aneurysm (LVA) varies. This study aimed to develop a risk prediction model for mortality after LVP.
Method:
A total of 741 patients with an ischaemic anterior-wall LVA who underwent LVP between January 1999 and March 2021 at Fuwai Hospital were retrospectively enrolled, and 22 clinical features were assessed. The entire cohort was randomly grouped into training and validation cohorts in a ratio of 8:2. Backward stepwise elimination approach and the least absolute shrinkage and selection operator regression were used for feature selection. A nomogram was developed based on a multivariable Cox regression model. The performance of the model was evaluated using discrimination and calibration. Decision curve analysis was performed to test the clinical usefulness.
Results:
The mean age was 58.6 (standard deviation 9.6) years, and 15.8% of the patients were female. The mean ejection fraction was 42.8% (8.5%). Coronary artery bypass grafting was performed in 93.4% of the patients. During a median follow-up of 60 months, 105 patients died. Eight features were selected and included in the multivariable Cox regression-based nomogram. The model achieved good calibration and discriminative ability as indicated by the concordance index (training 0.71; validation 0.77). Decision curve analysis showed the model had good clinical usefulness.
Conclusions:
In this study, a nomogram with relatively good performance was developed to predict individualised long-term mortality after LVP in patients with an ischaemic anterior-wall LVA. However, external validation is needed.
