Predicting heart failure
New app calculates patient's risk
LOS ANGELES, Calif – Elijah Ali and his son Rafee share a love for healthy eating and sports.
"[We] love to walk, love to run, play ball, [and] sports," Ali said.
"I get all my game from my dad," said Rafee. "He was the first one to put the ball in my hand when I was a little boy."
However, despite his active and healthy lifestyle, Ali developed heart failure at age 43 after a virus attacked his body.
"I was really shocked, and really dismayed," Ali explained.
Today Ali and his doctor are using a new app that calculates his risk of dying in the next five years.
UCLA researchers developed the app based on four variables: BNP level (which measures fluid retention), medication information, the New York Heart Association Classification (which measures shortness of breath caused by physical activity), and peak oxygen consumption (which measures the use of oxygen by the heart).
"We can develop a score that helps us predict a patient that will do well or is not going to do well," explained Martin Cadeiras, MD, Transplant Cardiologist, UCLA.
The app shows the probability of survival. Ali has over a 90 percent chance of surviving one year and nearly a 70 percent chance of surviving five years. This data helps doctors tailor treatments and advice.
"Basically, it just lets you know where you are and where you don't want to be," Ali explained.
Now is a good time for you to take the Take It To Heart Challenge:
More than a million Americans have heart attacks a year. The heart muscle needs a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with blood supply. Coronary artery disease causes the arteries to narrow and blood will not flow properly. Fatty matter, proteins, calcium, and inflammatory cells build up within the arteries to form plaques of different sizes. The plaque deposits are hard on the outside and soft on the inside. When plaque is hard, the outer shell cracks and platelets come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes "starved" for oxygen. Over time, death of heart muscle cells occurs, causing permanent damage. This is a heart attack. (Source: www.webmd.com)
DR. CADERIAS: "Heart disease is all about fluid. It's the heart not being able to perform well; it's too weak, so fluid backs up, for example to the lung or to the circulation and then accumulates inside the body. The other variable that is included in this score is whether the patient is on a specific medication. This medication is called an ACE inhibitor or an angiotensin receptor blocker. The fact that the patient is on that medication is good because it is linked to patients doing better over time; the fact that the patient is not on that may be an indicator the patient is worsening or is doing poorly. The third variable is what we call near heart association functional class that basically grades the degree of shortness of breath. Patients with heart failure have shortness of breath which is a manifestation of fluid that backs up to the lungs and the more shortness of breath that you have, the higher that score. The fourth variable is a little bit more complex to explain, but it's basically related to how we perform given exercise. An analogy can be when we get our car to measure the gas every year or every so often to see how the engine is working, so the emissions in the car are way of judging how our car is doing in general. And in the body is about the same. How well our heart is performing we can measure with a mask and the result of that evaluation we can plug it into the score as well. This is called cardiopulmonary exercise test and the result of that test is the fourth variable of this score."
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