Research on the risk factors and predictive model for intracardiac thrombosis in patients with dilated cardiomyopathy
10.19405/j.cnki.issn1000-1492.2024.04.024
- VernacularTitle:扩张型心肌病患者心内血栓形成危险因素及预测模型研究
- Author:
Jun LI
1
;
Zeping HU
;
Xuetao ZHU
Author Information
1. 安徽医科大学第一附属医院心血管内科,合肥 230022
- Keywords:
dilated cardiomyopathy;
intracardiac thrombosis;
nomogram;
risk factors;
left ventricular end-dias-tolic diameter;
brain natriuretic peptide;
β-blockers
- From:
Acta Universitatis Medicinalis Anhui
2024;59(4):708-714
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for intracardiac thrombosis in dilated cardiomyopathy(DCM)pa-tients and to construct,validate,and evaluate a nomogram prediction model based on these factors.Methods 88 patients diagnosed with DCM and complicated with intracardiac thrombus,and 544 patients without intracardiac thrombus were included.The participants were randomly divided into training and validation sets at a ratio of 7∶3.Using both univariate and multivariate Logistic regression analyses,independent risk factors for intracardiac thrombosis in DCM patients were identified.A nomogram prediction model was constructed using R software.The model's validity and performance were assessed using the receiver operating characteristic(ROC)curve,the Hos-mer-Lemeshow goodness-of-fit test,calibration curve,and decision curve.Results The binary Logistic regression analysis showed that age,atrial fibrillation,left ventricular end-diastolic diameter(LVEDD),brain natriuretic peptide(BNP),and β-blockers were independently associated with intracardiac thrombosis in DCM patients.Based on these five factors,a nomogram was constructed and validated.The area under the ROC curve for the training set was 0.823(95%CI:0.760～0.887)and0.803(95%CI:0.705～0.901)for the validation set,in-dicating a good discriminative ability.The Hosmer-Lemeshow test results for the calibration curve were(χ2=6.679,P=0.572)for the training set and(χ2=2.588,P=0.958)for the validation set,indicating a good fit between predicted and observed outcomes.The decision curve showed a high net clinical benefit in the threshold range of 0.05～0.92.Conclusion Based on age,atrial fibrillation,LVEDD,BNP,and β-blockers,the nomo-gram prediction model exhibits good discriminative and calibration abilities,and high clinical benefit.It can effec-tively guide clinicians in early intervention of risk factors,reducing the risk of intracardiac thrombosis in DCM pa-tients.
- Full text:2024070810052501565扩张型心肌病患者心内血栓形成危险因素及预测模型研究_李军.pdf
