Application of the seattle heart failure model in patients on cardiac resynchronization therapy

Laura Perrotta, Giuseppe Ricciardi, Paolo Pieragnoli, Marco Chiostri, Giulia Pontecorboli, Tiziana De Santo, Fulvio Bellocci, Nicola Vitulano, Michele Emdin, Giosuè Mascioli, Ilaria Ricceri, Maria Cristina Porciani, Antonio Michelucci, Luigi Padeletti

Research output: Contribution to journalArticlepeer-review


Background: The Seattle Heart Failure Model (SHFM) is a multimarker risk assessment tool able to predict outcome in heart failure (HF) patients. Aim: To assess whether the SHFM can be used to risk-stratify HF patients who underwent cardiac resynchronization therapy with (CRT-D) or without (CRT) an implantable defibrillator. Methods and Results: The SHFM was applied to 342 New York Heart Association class III-IV patients who received a CRT (23%) or CRT-D (77%) device. Discrimination and calibration of SHFM were evaluated through c-statistics and Hosmer-Lemeshow (H-L) goodness-of-fit test. Primary endpoint was a composite of death from any cause/cardiac transplantation. During a median follow-up of 24 months (25th-75th percentile [pct]: 12-37 months), 78 of 342 (22.8%) patients died; seven patients underwent urgent transplantation. Median SHFM score for patients with endpoint was 5.8 years (25th-75th pct: 4.25-8.7 years) versus 8.9 years (25th-75th pct: 6.6-11.8 years) for those without (P <0.001). Discrimination of SHFM was adequate for the endpoint (c-statistic always ranged around 0.7). The SHFM was a good fit of death from any cause/cardiac transplantation, without significant differences between observed and SHFM-predicted survival. Conclusion: The SHFM successfully stratifies HF patients on CRT/CRT-D and can be reliably applied to help clinicians in predicting survival in this clinical setting.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Issue number1
Publication statusPublished - Jan 2012


  • cardiac resynchronization therapy
  • heart failure
  • Seattle Heart Failure Score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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