Prognostic index of hypertensive cardiopathy evolutionary changes: from mild diastolic dysfunction to depressed systolic function.

Abstract

Hypertensive cardiopathy is a variable and complex group of effects that can provoke a chronic elevation of arterial pressure in the heart. Its morbidity and mortality are increasing. To evaluate the capacity of an index based on prognostic factors to predict the evolution of hypertensive cardiopathy with mild diastolic dysfunction to depressed systolic function. We carried out a prospective cohort study in patients with hypertensive cardiopathy, followed at the specialized arterial hypertension physician's office of the Specialty Policlinic attached to "Carlos Manuel de Céspedes" General University Hospital, Bayamo Municipality, Granma Province, Cuba. The period evaluated was from Jan 1, 2008, to Dec 31, 2021. The patients followed had at least four appointments per year. Index internal validity. The mean values of the proposed index were twice as high in patients with hypertensive heart disease with depressed systolic function (mean: 11.05; p= 0.000) than in those who did not develop it. The optimal cutpoint was seven (sensitivity: 92.2 {IC: 88.94 to 95.42}; specificity: 86.7 {IC: 81.67 to 87.17}; validity index 86.7 {IC: 84.55 to 88.85}). External validity. The index showed excellent discriminative ability (area under the ROC curve of 0.954), and the calibration was adequate (Hosmer and Lemeshow: X2= 3.485; p= 0.900). The index obtained for the prognosis of hypertensive cardiopathy evolutionary changes from normal ejection fraction to cardiac insufficiency with reduced ejection fraction has an adequate predictive capacity and calibration, as well as accuracy and reliability. Keywords: hypertension, hypertensive cardiopathy, prognostic factors, prognostic index.