The Value of Ratio of Hypersensitive C-reactive Protein to Prealbumin and Tei Index in Evaluating Volume Load in Patients with Acute Decompensated Heart Failure
YANG Geng
Abstract：Objective:To investigate the value of ratio of hypersensitive C-reactive protein to prealbumin(hs-CRP/PAB)and Tei index in evaluating volume load in patients with acute decompensated heart failure(ADHF).Methods:A total of 192 ADHF patients were selected and divided into normal volume load group(68 cases)and volume overload group(124 cases)according to patient capacity load status.The differences of general data,clinical indexes,and cardiac function indexes were compared between the two groups.Multivariate Logistic regression analysis was used to screen factors affecting volume overload in ADHF patients,and a Logistic regression model was established to analyze the correlation strength between hs-CRP/PAB,Tei index and volume overload in ADHF patients.The neural network model was established and the influencing factors were ranked according to importance.Receiver operating characteristic(ROC)curves were used to evaluate the predictive efficacy of the two models.Logistic regression analysis was used to evaluate the interaction between hs-CRP/PAB and Tei index in evaluating volume load in ADHF patients.Results:The levels of age,Tei index,hypersensitive C-reactive protein(hs-CRP),hs-CRP/PAB,urea nitrogen(BUN),creatinine(Scr),and N-terminal B-type diuretic natriuretic peptide(NT-proBNP)in the volume overload group were higher than those in the normal volume load group,and the level of prealbumin(PAB)in the volume overload group was lower than that in normal volume load group,the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that age,Scr,hs-CRP/PAB,Tei index,and NT-proBNP were risk factors for volume overload in ADHF patients(P＜0.05).The correlation intensity of hs-CRP/PAB and Tei index,with volume load was nonlinear dose response(P＜0.01).Logistic regression model and neural network model were established to predict the probability of volume overload in ADHF patients.The area under ROC curve(AUC)of Logistic regression model and neural network model were 0.934 and 0.955,respectively.When the sensitivity and specificity of Logistic regression model were 86.5%and 91.1%,respectively,the Yoden index was 0.776,and the accuracy was 88.8%.When the sensitivity and specificity of the neural network model were 86.7%and 91.6%,respectively,the Yoden index was 0.783,and the accuracy was 89.1%.The AUC,Yoden index and accuracy of neural network model were high.After adjusting for the mixed factors,hs-CRP/PAB interacted with Tei index,hs-CRP/PAB≥5.62×10-2 interacted with Tei index≥0.52,and ADHF patients showed a higher risk of volume overload when the two factors were co-existed(OR=6.113,95%CI 2.448-10.669).Conclusion:Age,Scr,hs-CRP/PAB,Tei index,and NT-proBNP were risk factors for volume overload in ADHF patients.hs-CRP/PAB and Tei index interacted.When hs-CRP/PAB≥5.62×10-2 and Tei index≥0.52,the risk of volume overload in ADHF patients was significantly increased.
Keywords：acute decompensated heart failureratio of hypersensitive C-reactive protein to prealbuminTei indexvolume load
Publication Date：2025-03-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 822-829 )