title: [Prognosis of unfavorable cardiac events in patients with severe chronic heart failure with preserved coronary myocardial reserve].
abstract: OBJECTIVE
  To elucidate predictors of unfavorable cardiac events in patients with non-ischemic cardiomyopathy (CMP) complicated by congestive heart failure (CHF) with preserved myocardial coronary reserve (MCR).
  
  
  METHODS
  We followed 114 patients with non-ischemic MCP and NYHA class III-IV CHF. MCR was estimated by dobutamine stress-echocardiography (SEchoCG). Prior to SEchoCG we measured blood von Willebrand factor (vWF) activity, content of endothelin-1 (ET), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), soluble vascular cell adhesion molecule-1 (sVCAM-1) and nitric oxide stable metabolites. At peak of dobutamine test blood was collected for measurement of ET, vWF, and NT-proBNP concentrations. Left ventricular ejection fraction (LVEF)sechoCG, ETsechoCG, vWFsechoCG and NT-proBNPsechoCG were calculated as percentage changes of these parameters from baseline at peak dobutamine load.
  
  
  RESULTS
  Groups with low and preserved MCR were not different by relative number of patients with unfavorable course of the disease (41.2 and 34.8%, p = 0.529, respectively). The following parameters were predictors of development of unfavorable cardiac events in patients with preserved MCR (LVEFsechoCG > 10%) during 24 months: initial hsCRP > 5.2 mg/ml, LVEFsechoCG < 19.7% and ETsechoCG > 11.8%. Logistic regression model combined with binary values of LVEFsechoCG and ETsechoCG demonstrated best prognostic efficacy (sensitivity--86.7%, specificity--83.3%, prognostic accuracy--84.6%).
authors: E K
authors: EK
authors: Kurlianskaia
authors: T L
authors: TL
authors: Denisevich
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D018450:Disease Progression; D025401:Echocardiography, Stress / Q000379:methods; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D016277:Ventricular Function, Left; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D019332:Endothelin-1; D010446:Peptide Fragments; D019010:Vascular Cell Adhesion Molecule-1; C109794:pro-brain natriuretic peptide (1-76); D014841:von Willebrand Factor; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein