Featured articleSelecting patients for heart transplantation: Comparison of the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM)
Section snippets
Study patients and data collection
Seven hundred fifteen consecutive patients with systolic heart failure referred to the Columbia University Medical Center for heart transplant evaluation underwent cardiopulmonary exercise testing and collection of variables in the HFSS and SHFM. Clinical characteristics are listed in Table 1. Review of the data was approved by the local human investigations committee.
The HFSS includes 7 parameters: resting heart rate (HR); mean blood pressure (mBP); left ventricular ejection fraction (LVEF);
Baseline characteristics and outcomes
The clinical characteristics and outcomes are listed in Table 1. The mean HFSS was 8.04 ± 0.89 and the mean SHFM score was 0.822 ± 0.933. The HFSS and SHFM were modestly correlated (R = −0.48, p < 0.001; Figure 1A), but more so than the peak VO2 alone vs SHFM (R = −0.36, p < 0.001; Figure 1B).
During a mean follow-up of 962 ± 912 days, 354 outcome events (49.5%) occurred; 170 patients underwent urgent heart transplantation, 148 patients died, 36 received LVAD implantation, 35 patients underwent
Discussion
We have presented two novel findings in a CHF population referred for heart transplantation: (1) the SHFM and HFSS are similarly strong; and (2) combining the SHFM and HFSS improves predictive power. We have also shown that the SHFM is valid for transplant selection, which was previously not established.11, 17
Disclosure statement
This work was supported by grants from the Stockholms Läns Landsting and the Swedish Heart–Lung Foundation, Stockholm, Sweden (to L.H.L.); the Division of Research Resources, General Clinical Research Centers Program, National Institutes of Health (5 MO1 RR00645), Bethesda, MD; the Foundation for Cardiac Therapies (FACT Fund), New York, NY; and the Altman Fund, New York, NY (to D.M.). None of the authors have any conflicts of interest to disclose.
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