Analysis of prognostic indicators and predictive value in patients with heart failure with preserved ejection fraction

Sun Jing; Liu Peng; Meng Chang; Bai Ying; Li Li; Hu Luowen; Yan Yupeng; Fan Yudong; Zheng Shanhai

doi:10.3969/j.issn.1671-6450.2025.06.007

Abstract：Objective To explore the predictive value of waist to height ratio(WHTR),glycated hemoglobin(HbA1c),high-density lipoprotein cholesterol(HDL-C),systolic blood pressure(SBP),and diastolic blood pressure(DBP)indi-cators for the prognosis of patients with preserved ejection fraction heart failure(HFpEF).Methods A retrospective study was conducted on 183 patients with HFpEF who visited the Emergency General Hospital from February 2021 to February 2022.All patients were followed up for one year after standardized treatment.The patients were divided into MACE group(49 cases)and No MACE group(134 cases)based on their readmission due to major adverse cardiovascular events(MACE)with-in one year.The clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the factors affecting the poor prognosis of HFpEF patients,and receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of WHTR,HbA1c,HDL-C,SBP,and DBP in evaluating poor prognosis at admission.Results The incidence of MACE in 183 patients during the 1-year follow-up period was 26.78％(49/183).Compared with the No MACE group,the MACE group had significantly higher HbA1c,SBP,DBP,BMI,WC,troponin Ⅰ,NT proBNP,NYHA functional class Ⅲ+Ⅳratio,systemic inflammatory index(SII),and neutrophil to lymphocyte ratio(NLR),while WHTR,HDL-C,and left ventricular ejection fraction(LVEF)were lower than those in the No MACE group,and the differences were statistically significant(P＜0.05);Through multiple logistic regression analysis,the results showed that high WHTR and HDL-C were independent protec-tive factors affecting poor prognosis in HFpEF patients[OR(95％CI)=0.874(0.786-0.971),0.855(0.757-0.965),all P＜0.05],while high SII,NLR,and NYHA functional class Ⅲ+Ⅳ were independent risk factors[OR(95％CI)=1.143(1.013-1.291),1.134(1.024-1.256),2.784(1.121-6.913),all P＜0.05].The ROC curve shows that the area under the curve of WHTR,HbA1c,HDL-C,SBP,and DBP predicting poor prognosis is 0.845,0.732,0.785,0.669,and 0.683,respectively,indi-cating good predictive value.Conclusion WHTR,HDL-C,NYHA functional classification,SII,and NLR can affect the re-admission of HFpEF patients after treatment with MACE,leading to a higher incidence of adverse prognosis.WHTR,HbA1c,HDL-C,SBP,and DBP have important predictive value for their adverse prognosis.