Prediction of sudden death in elderly patients with heart failure

作     者：Ana Ayesta Helena Martinez-Sellest Antonio Bayes de Luna Manuel Martinez-Selles 

作者机构：Cardiology Department Hospital Universitario del Sureste Arganda del Rey Madrid Spain Universidad Complutense Madrid Spain Fundacio lnvestigacio Cardiovascular ICCC Hospital de Sant Pau Barcelona Spain Cardiology Department Hospital General Universitario Gregorio Maranon CIVERCK Universidad Europea Madrid Spain 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2018年第15卷第2期

页      面：185-192页

核心收录：

学科分类：07[理学] 08[工学] 0815[工学-水利工程] 0713[理学-生态学] 

主　　题：Heart failure Prediction Risk Sudden death The elderly 

摘      要：Most heart failure （HF） related mortality is due to sudden cardiac death （SCD） and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most works include no or few patients with advanced age, and the prevention of SCD in elderly patients with HF is still controversial. A recent reduction in the annual rate of SCD has been recently described but it is not clear if this is also true in advanced age patients. Age is associated with SCD, although physicians frequently have the perception that elderly patients with HF die mainly of pump failure, underestimating the importance of SCD. Other clinical variables that have been associated to SCD are symptoms, New York Heart Association functional class, ischemic cause, and comorbidities （chronic obstructive pulmonary disease, renal dysfunction and diabetes）. Some test results that should also be considered are left ventricular ejection fraction and diameters, natriuretic peptides, non-sustained ventricular tachycardias and autonomic abnormalities. The combination of all these markers is probably the best option to predict SCD. Different risk scores have been described and, although there are no specific ones for elderly populations, most include age as a risk predictor and some were developed in populations with mean age 〉 65 years. Finally, it is important to stress that these scores should be able to predict any type of SCD as, although most are due to tachyarrhythmias, bradyarrhythmias also play a role, particularly in the case of the elderly.