Background:Dilated cardiomyopathy(DCM)has a high mortality rate and is the most common indication for heart transplantation.Our study sought to develop a multiparametric nomogram to assess individualized all-cause mortality or heart transplantation(ACM/HTx)risk in DCM patients. Methods:The present study is a retrospective cohort study.The demographic,clinical,blood test,and cardiac magnetic resonance imaging(CMRI)data of DCM patients in the tertiary center(Fuwai Hospital)were collected.The primary endpoint was ACM/HTx.The least absolute shrinkage and selection operator(LASSO)Cox regression model was applied for variable selection.Multivariable Cox regression was used to develop a nomogram.The concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and decision curve analysis(DCA)were used to evaluate the performance of the nomogram. Results:A total of 218 patients were included in the present study.They were randomly divided into a training cohort and a validation cohort.The nomogram was established based on eight variables,including mid-wall late gadolinium enhancement,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume index,free triiodothyronine,and N-terminal pro-B type natriuretic peptide.The AUCs regarding 1-year,3-year,and 5-year ACM/HTx events were 0.859,0.831,and 0.840 in the training cohort and 0.770,0.789,and 0.819 in the validation cohort,respectively.The calibration curve and DCA showed good accuracy and clinical utility of the nomogram. Conclusions:We established and validated a circulating biomarker-and CMRI-based nomogram that could provide a personalized prediction of ACM/HTx for DCM patients,which might help risk stratification and decision-making in clinical practice.
Yupeng Liu;Wenyao Wang;Jingjing Song;Jiancheng Wang;Yi Fu;Yida Tang
Department of Cardiology,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China||Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,ChinaDepartment of Cardiology,Institute of Vascular Medicine,Peking University Third Hospital,Beijing 100191,China||Key Laboratory of Molecular Cardiovascular Science,Ministry of Education,Beijing 100191,ChinaDepartment of Cardiology,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,ChinaBeijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems,State Key Laboratory of Natural and Biomimetic Drugs,School of Pharmaceutical Sciences,Peking University,Beijing 100083,ChinaDepartment of Physiology and Pathophysiology,School of Basic Medical Sciences,Peking University Health Science Center,Beijing 100083,China
Cardiomyopathy,dilated;Heart transplantation;Mortality;Nomograms;Least absolute shrinkage and selection op-erator;Decision curve analysis
《中华医学杂志（英文版）》 2024 (001)
73-81 / 9
This work was supported by the Medical Scientific Research Foundation of Guangdong Province(B2023012);the National Key R&D Program of China(Grant No.2020YFC2004705);the Research Unit of Medical Science Research Management/Basic and Clinical Research of Metabolic Cardiovascular Diseases from the Chinese Academy of Medical Sciences(Grant No.2021RU003);the National Natural Science Foundation of China(Grant Nos.81825003,91957123,81800327,81900272);Beijing Nova Program(Grant No.Z201100006820002)from the Beijing Municipal Science & Technology Commission;and the Science and Technology Project of Xicheng District Finance(Grant No.XCSTS-SD2021-01).
10.1097/CM9.0000000000002688
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