Wu Meiyin, Lai Weilin, Huo Xuan, Wang Qianru, Zhou YueShengzi, Gao Dongmei
Department of General Internal Medicine, Zhejiang Medical & Health Group Hangzhou Hospital, Hangzhou, Zhejiang, 310022, China.
Department of Medical Oncology, Zhejiang Medical & Health Group Hangzhou Hospital, Hangzhou, Zhejiang, 310022, China.
BMC Cardiovasc Disord. 2025 Mar 7;25(1):160. doi: 10.1186/s12872-025-04591-1.
Visceral Adiposity Index (VAI) is an effective predictor of metabolic syndrome (MetS) and serves as a marker of visceral adiposity. The association between the VAI index and poor prognosis in patients with MetS and Heart failure with reduced ejection fraction (HFrEF) remains unclear. The aim of this study is to evaluate the relationship between VAI and endpoint events in patients with metabolic syndrome and HFrEF.
This study was a single-center retrospective cohort study. A total of 809 patients with MetS and HFrEF admitted to Hangzhou Hospital of Zhejiang Medical Group from January 2014 to September 2021 were consecutively included. The VAI index was calculated based on anthropometric measurements and laboratory examination results at admission, and patients were grouped according to tertiles of VAI index. All patients were followed for 24 months, and the incidence of cardiac death and readmission for heart failure was recorded.
For different clinical endpoint events, there were significant differences in event-free survival between tertiles of VAI index. The risk of cardiac death [hazard ratio (HR):3.402, 95%CI:2.123-5.449, P < 0.001] and heart failure readmission (HR:4.862, 95%CI:3.605-6.557, P < 0.001) increased with the increase of tertile of VAI index. Multivariate COX regression analysis adjusted for other confounding factors showed that VAI was an independent predictor of clinical adverse endpoint events. The predictive value of VAI for cardiac death [Area under curve (AUC):0.649, 95%CI:0.602-0.697, P < 0.001] and heart failure readmission (AUC:0.693, 95%CI:0.656-0.729, P < 0.001) was higher than that of other variables.
In patients with HFrEF at risk for comorbid metabolic diseases, baseline VAI levels on admission were associated with the occurrence of adverse outcomes during follow-up.
内脏脂肪指数（VAI）是代谢综合征（MetS）的有效预测指标，也是内脏肥胖的标志物。VAI指数与代谢综合征和射血分数降低的心力衰竭（HFrEF）患者预后不良之间的关系尚不清楚。本研究旨在评估VAI与代谢综合征和HFrEF患者终点事件之间的关系。
本研究为单中心回顾性队列研究。连续纳入2014年1月至2021年9月在浙江省立同德医院住院的809例代谢综合征合并HFrEF患者。根据入院时的人体测量和实验室检查结果计算VAI指数，并根据VAI指数的三分位数对患者进行分组。所有患者随访24个月，记录心源性死亡和因心力衰竭再次入院的发生率。
对于不同的临床终点事件，VAI指数三分位数之间的无事件生存率存在显著差异。心源性死亡风险[风险比（HR）：3.402，95%置信区间（CI）：2.123 - 5.449，P < 0.001]和心力衰竭再次入院风险（HR：4.862，95%CI：3.605 - 6.557，P < 0.001）随着VAI指数三分位数的增加而增加。在调整了其他混杂因素的多变量COX回归分析中，VAI是临床不良终点事件的独立预测因子。VAI对心源性死亡的预测价值[曲线下面积（AUC）：0.649，95%CI：0.602 - 0.697，P < 0.001]和心力衰竭再次入院的预测价值（AUC：0.693，95%CI：0.656 - 0.729，P < 0.001）高于其他变量。
在有合并代谢性疾病风险的HFrEF患者中，入院时的基线VAI水平与随访期间不良结局的发生有关。
