一种现象映射工具和临床评分,用于识别急性减补性心力衰竭中低利尿效率
Matthew W Segar1, Muhammad Shahzeb Khan2, Kershaw V Patel3
1Department of Cardiology, Texas Heart Institute, Houston, Texas, USA.
JACC. Heart failure
|December 15, 2023
概括
这项研究开发了一种机器学习现象映射策略和BAN-ADHF评分,以识别患有急性不补偿性心力衰竭 (ADHF) 的患者,其利尿效率低. 这种方法有助于量身定制脱塞疗法,并预测患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有急性不补偿性心力衰竭 (ADHF) 的患者对利尿剂治疗的反应有所变化.
- 需要早期识别低利尿效率,以指导ADHF的脱策略.
研究的目的:
- 开发和验证基于机器学习的现象映射方法.
- 创建和验证基于整数的尿液分数 (BAN-ADHF分数) 来识别在ADHF中尿液效率低的患者.
主要方法:
- 来自ADHF试验 (ROSE-AHF,CARRESS-HF,ATHENA-HF) 的数据汇总用于导出.
- 使用多变量有限混合模型的现象映射来识别利尿效率现象组.
- 现象组的外部验证以及在聚合ADHF试验中BAN-ADHF得分的开发/验证 (DOSE/ESCAPE).
主要成果:
- 根据利尿效率确定了三个现象组 (P < 0.001).
- BAN-ADHF得分显示了低利尿效率的高预测性表现 (C指数:0.92),优于单个临床标记.
- 较高的BAN-ADHF得分与较差的全球福祉,增加的尿水平,更长的住院时间和更高的住院死亡率相关.
结论:
- 经过验证的现象映射策略和尿液评分 (BAN-ADHF) 可以识别具有不同尿液反应的ADHF患者.
- 开发的得分与临床结果相关,例如停留时间和死亡率.
- 这种方法可以为ADHF提供个性化的脱塞疗法.
相关概念视频
Heart Failure Drugs: Diuretics
395
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
395
Factors Affecting Renal Clearance: Renal Impairment
98
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
98
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436


