UCLA Researchers Develop New Calculator to Assess Appropriate Treatment for Heart Failure

January 29, 2014

By Fran Kritz

Researchers at UCLA have developed a new “risk calculator” to help predict heart failure patients’ chances of survival for up to five years. The goal of the calculator is to help physicians determine how aggressively to treat a patient for the condition.

The new calculator was a better predictor of outcomes compared to two other available calculators, says Tamara Horwich, M.D., an assistant professor of medicine and cardiology at UCLA, and one of the study’s authors.

More than five million Americans suffer from heart failure, according to the American Heart Association, which occurs when the heart can no longer pump enough blood to the body’s other organs.

To develop the risk calculator, the UCLA team used data from 2,255 heart failure patients, who were referred to the UCLA Cardiomyopathy Center between 2000 and 2011 and identified 39 patient variables, including age, weight, medications, lab work and the results of diagnostic tests. The model was based on data from patients treated at the hospital between 2000 and 2007, and tested on patients treated between 2008 and 2011.

Based on their research, the study authors determined four pieces of information that doctors enter into the calculator to determine appropriate treatment for a heart failure patient:

  • B-type natriuretic peptide level-a substance secreted from the heart’s ventricles (lower chambers) in response to changes in pressure. The level of BNP in the blood increases when heart failure symptoms worsen and decreases when the condition is more stable.
  • Peak oxygen consumption: levels of oxygen get lower as heart failure worsens.
  • New York Heart Association classification: classifies patients based on how limited they are in physical activity because of heart failure.
  • Heart failure medications

Doctors enter in the four facts about a patient and the survival measures are automatically calculated. ”Patients at very high risk based on the calculator might consider very aggressive therapies such as a heart transplant or the surgical implantation of a heart assist device,” says Gregg C. Fonarow, M.D., professor of Cardiovascular Medicine and Science and director of the Ahmanson–UCLA Cardiomyopathy Center. “Patients at lower risk may be able to avoid excess treatment,” Fonarow says.

Currently, the risk calculator is used as an Excel spreadsheet, but the research team also is also developing a phone app.

The study was funded by the Iris Cantor–UCLA Women’s Health Center and the Ahmanson Foundation and published in the journal Circulation: Heart Failure.

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