scholarly journals THE SEATTLE HEART FAILURE MODEL MAY NOT BE APPROPRIATE AS A REFERRAL TOOL FOR PALLIATIVE CARE

2017 ◽  
Vol 33 (10) ◽  
pp. S44
Author(s):  
N. Ng Fat Hing ◽  
D. Chan ◽  
H. Liu ◽  
Y. Lu ◽  
A. Malik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Failure Model ◽  
Referral Tool ◽  
Heart Failure Model

Utility of the Seattle Heart Failure Model for palliative care referral in advanced ambulatory heart failure

2018 ◽  
pp. bmjspcare-2018-001626 ◽  
Author(s):  
Nicholas Ng Fat Hing ◽  
Jane MacIver ◽  
Derrick Chan ◽  
Helen Liu ◽  
Yu Tong Linda Lu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Clinical Utility ◽  
Left Ventricular Ejection ◽  
Failure Model ◽  
Event Free Survival ◽  
Free Survival ◽  
C Statistic ◽  
Risk Patients ◽  
Heart Failure Model

BackgroundPhysicians face uncertainty when predicting death in heart failure (HF) leading to underutilisation of palliative care. To facilitate decision-making, we assessed the Seattle Heart Failure Model (SHFM) as a referral tool by evaluating its performance in predicting 1-year event-free survival from death, heart transplant (HTx), and ventricular assist device (VAD) implantation.MethodsWe retrospectively reviewed the charts of consecutive patients with advanced ambulatory HF with New York Heart Association Class III/IV HF and a left ventricular ejection fraction of ≤40% from 2000 to 2016. We evaluated SHFM’s performance by using the Cox proportional hazards model, its discrimination using the c-statistic, its calibration by comparing the observed and predicted survival and its clinical utility by hypothetically assessing the proportion of patients adequately or inadequately referred to palliative care.ResultsWe included 612 patients in our study. During the 1-year follow-up, there were 83 deaths, 4 HTx and 1 VAD. Although SHFM showed very good discrimination (c-statistic=0.71) and adequate calibration in medium to low-risk patients, it underestimated event-free survival by 12% in high-risk patients. SHFM’s clinical utility was limited: 33% of eligible patients would have missed the opportunity for referral and only 27% of referred patients would have benefited.ConclusionUse of SHFM could result in a high proportion of referrals while capturing the majority of patients who may benefit from palliative care. Though this may be a more encompassing and safer alternative than current referral practices, it could lead to many early referrals.

THE EFFECTS OF STRESS ON CARDIAC MECHANICAL DYSSYNCHRONY IN A HEART FAILURE MODEL

2014 ◽  
Vol 30 (10) ◽  
pp. S126
Author(s):  
S. Salimian ◽  
B. Thibault ◽  
V. Finnerty ◽  
J. Grégoire ◽  
F. Harel
Keyword(s):  
Heart Failure ◽  
Mechanical Dyssynchrony ◽  
Failure Model ◽  
Effects Of Stress ◽  
Heart Failure Model

scholarly journals Effects of captopril on the beta-adrenergic system in noninfarcted myocardium in the rat heart failure model

1991 ◽  
Vol 17 (2) ◽  
pp. A133 ◽  
Author(s):  
Karil Bellah ◽  
Thomas Raya ◽  
Sheldon Litwin ◽  
Steven Goldman ◽  
Joel Karliner
Keyword(s):  
Heart Failure ◽  
Rat Heart ◽  
Adrenergic System ◽  
Failure Model ◽  
Beta Adrenergic ◽  
Heart Failure Model

Echocardiography Evaluation of a Novel Stable Ovine Heart Failure Model Suitable for Cardiovascular Device Testing

2011 ◽  
Author(s):  
Peter W. Walsh ◽  
Craig S. McLachlan ◽  
Leigh Ladd ◽  
Arie Blitz ◽  
R. Mark Gillies ◽  
...  
Keyword(s):  
Heart Failure ◽  
Animal Models ◽  
Large Animal ◽  
Failure Model ◽  
Large Animal Models ◽  
Surgical Model ◽  
Coronary Ligation ◽  
Rapid Ventricular Pacing ◽  
Heart Failure Model ◽  
Underlying Pathology

Numerous large animal models of chronic cardiac ischemia have been developed to explore either pathological mechanisms and or device interventions in developed heart failure models. Traditionally chronic heart failure in large animal models such as sheep or pigs has been induced by either coronary ligation with or without reperfusion. Coronary ligation is often attempted in the open chest surgical model or more recently in the closed chest animal via angiography [1]. Both techniques can be challenging and also induce high mortality with the risk of myocardial stunning and resultant shock and or lethal arrhythmias. There is also difficulty in developing stable heart failure across cases where infarct sizes can be variable. One strategy to over come this variability has been via rapid ventricular pacing, however inducing heart failure does not induce sustained heart failure in many cases if the pacing is switched off, and additionally pacing does not induce some of the underlying pathology seen in the development of heart failure [1].

Sign in / Sign up

Export Citation Format

Share Document