Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Guangxi Key Laboratory Base of Precision Medicine in Cardiocerebrovascular Diseases Control and Prevention, Nanning, People's Republic of China.
Sci Rep. 2023 Nov 2;13(1):18889. doi: 10.1038/s41598-023-46338-y.
To determine the risk factors for dilated cardiomyopathy (DCM) and construct a risk model for predicting HF in patients with DCM, We enrolled a total of 2122 patients, excluding those who did not meet the requirements. A total of 913 patients were included in the analysis (611 males and 302 females) from October 2012 to May 2020, and data on demographic characteristics, blood biochemical markers, and cardiac ultrasound results were collected. Patients were strictly screened for DCM based on the diagnostic criteria. First, these patients were evaluated using propensity score matching (PSM). Next, unconditional logistic regression was used to assess HF risk. Furthermore, receiver operating characteristic (ROC) curve analysis was conducted to determine diagnostic efficiency, and a nomogram was developed to predict HF. Finally, the Kaplan‒Meier survival curve was plotted. Of the initial 2122 patients, the ejection fraction (EF) in males was worse. We included 913 patients after the final DCM diagnosis. The results showed that the levels of NT-proBNP, WBC, PLT, neutrophils, lymphocytes, eosinophils, and IL-6, C-reactive protein (CRP) and the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and CRP/lymphocyte ratio (CLR) were higher in males than in females (P < 0.001-0.009). The nomogram showed that factors such as sex, WBC, neutrophils, PLR, and CLR could predict the risk of worsening cardiac function in patients with DCM before and after PSM (P < 0.05). The ROC curve showed that CLR with an 85.6% area demonstrated higher diagnostic efficacy than the NLR (77.0%) and PLR (76.6%, P < 0.05). Survival analysis showed a higher mortality risk in females with higher CLR levels (P < 0.001-0.009). However, high CLR levels indicated a higher mortality risk (P < 0.001) compared to sex. Male EF is lower in DCM patients. CLR could predict the risk of declined cardiac function in patients with DCM. The mortality in females with higher CLR levels was highest; however, the exact mechanism should be investigated.
为了确定扩张型心肌病（DCM）的危险因素，并构建预测 DCM 患者心力衰竭（HF）的风险模型，我们共纳入了 2122 例患者（排除不符合要求的患者）。共纳入 913 例患者（男 611 例，女 302 例），这些患者均于 2012 年 10 月至 2020 年 5 月在我院接受诊治，收集了患者的人口统计学特征、血液生化标志物和心脏超声结果等数据。根据诊断标准严格筛选 DCM 患者。首先，我们采用倾向评分匹配（PSM）对这些患者进行评估。其次，采用非条件 logistic 回归评估 HF 风险。进一步采用受试者工作特征（ROC）曲线分析评估诊断效率，并构建预测 HF 的列线图。最后，绘制 Kaplan-Meier 生存曲线。在最初的 2122 例患者中，男性的射血分数（EF）较差。经过最终的 DCM 诊断后，我们共纳入 913 例患者。结果显示，男性的 NT-proBNP、白细胞（WBC）、血小板（PLT）、中性粒细胞、淋巴细胞、嗜酸性粒细胞、白细胞介素 6（IL-6）、C 反应蛋白（CRP）和中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、CRP/淋巴细胞比值（CLR）水平均高于女性（P<0.001-0.009）。列线图显示，PSM 前后，性别、WBC、中性粒细胞、PLR、CLR 等因素可预测 DCM 患者心功能恶化的风险（P<0.05）。ROC 曲线显示，CLR 的曲线下面积为 85.6%，高于 NLR（77.0%）和 PLR（76.6%，P<0.05）。生存分析显示，CLR 水平较高的女性死亡率风险更高（P<0.001-0.009）。但是，与性别相比，CLR 水平升高预示着更高的死亡率风险（P<0.001）。DCM 患者中男性 EF 较低。CLR 可预测 DCM 患者心功能下降的风险。CLR 水平较高的女性死亡率最高；但是，确切机制仍需进一步研究。
