Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853, China.
General Department of Zhengzhou First People's Hospital, #56 Dong Dajie, Guancheng Hui District, Zhengzhou City, 450000, Henan Province, China.
BMC Cardiovasc Disord. 2021 May 28;21(1):263. doi: 10.1186/s12872-021-02080-9.
Abdominal obesity as a predominant comorbidity has played a key role in the incidence and worsening of heart failure with preserved ejection fraction (HFpEF), and waist-to-height ratio (WHtR) behaves better than waist circumference or body mass index in evaluating abdominal obesity. While the association between WHtR and all-cause death in Chinese patients with HFpEF remains unclear.
Patients with stable HFpEF (N = 2041) who presented to our hospital from January 2008 to July 2019 were divided into low-WHtR (< 0.5, N = 378) and high-WHtR (≥ 0.5, N = 1663). Multivariable Cox proportional-hazard models were used to examine the association of WHtR with all-cause death.
The average age was 76.63 ± 11.44 years, and the mean follow-up was 4.53 years. During follow-up, 185 patients (9.06%) reached the primary outcome of all-cause death. As for the secondary outcome, 79 patients (3.87%) experienced cardiovascular death, 106 (5.19%) had non-cardiovascular death, and 94 (4.61%) had heart failure rehospitalization. After multivariable adjustment, a higher WHtR was significantly associated with the increased risks of all-cause death [adjusted hazard ratios (HR) 1.91, 95% confidence interval (CI) 1.06-3.45, p = 0.032], cardiovascular death (adjusted HR 2.58; 95% CI 1.01-6.67, p = 0.048), and HF rehospitalization (adjusted HR 3.04; 95% CI 1.26-7.31, p = 0.013).
Higher WHtR is an independent risk factor for all-cause death in Chinese patients with HFpEF.
作为主要合并症的腹型肥胖在射血分数保留的心力衰竭（HFpEF）的发病率和恶化中起着关键作用，而腰围身高比（WHtR）在评估腹型肥胖方面的表现优于腰围或体重指数。然而，WHtR 与中国 HFpEF 患者全因死亡之间的关系尚不清楚。
2008 年 1 月至 2019 年 7 月期间我院收治的稳定 HFpEF 患者（N=2041）分为低 WHtR（<0.5，N=378）和高 WHtR（≥0.5，N=1663）。采用多变量 Cox 比例风险模型来检验 WHtR 与全因死亡的关系。
患者平均年龄为 76.63±11.44 岁，平均随访时间为 4.53 年。随访期间，185 例患者（9.06%）达到全因死亡的主要终点。次要终点方面，79 例（3.87%）发生心血管死亡，106 例（5.19%）发生非心血管死亡，94 例（4.61%）发生心力衰竭再住院。经多变量调整后，较高的 WHtR 与全因死亡风险增加显著相关[调整后的危险比（HR）1.91，95%置信区间（CI）1.06-3.45，p=0.032]、心血管死亡（调整后的 HR 2.58；95% CI 1.01-6.67，p=0.048）和心力衰竭再住院（调整后的 HR 3.04；95% CI 1.26-7.31，p=0.013）。
较高的 WHtR 是中国 HFpEF 患者全因死亡的独立危险因素。
