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射血分数降低的心力衰竭患者中全免疫炎症值的预后意义

The Prognostic Significance of the Pan-Immune-Inflammation Value in Patients with Heart Failure with Reduced Ejection Fraction.

作者信息

Dervis Emir, Yakut Idris, Inan Duygu

机构信息

Department of Cardiology, Medipol University, 34815 Istanbul, Turkey.

Department of Cardiology, Sincan Training and Research Hospital, 06949 Ankara, Turkey.

出版信息

Diagnostics (Basel). 2025 Jun 25;15(13):1617. doi: 10.3390/diagnostics15131617.

DOI:10.3390/diagnostics15131617
PMID:40647616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12249291/
Abstract

We aimed to investigate the association between the pan-immune-inflammation value (PIV) and mortality in patients with heart failure with a reduced ejection fraction (HFrEF), along with clinical and biochemical parameters. : In this retrospective cohort study, 419 patients diagnosed with HFrEF between January 2014 and December 2023 were analyzed. Data on demographic features, comorbidities, cardiac parameters [New York Heart Association (NYHA) classification, left ventricular ejection fraction (LVEF), ventricular dimensions], medication use, and laboratory findings (PIV, N-terminal pro-B-type natriuretic peptide [NT-proBNP], electrolytes, and complete blood count) were collected from institutional and national records. : Mortality occurred in 22.91% of patients. PIV > 696 was significantly associated with mortality (sensitivity: 37.5%, specificity: 78.64%, = 0.006), but it was not an independent predictor in multivariate analysis. Instead, low body mass index (BMI), increased end-systolic diameter, reduced LVEF, advanced NYHA class (III/IV), elevated NT-proBNP, hyponatremia, and lymphopenia were identified as independent predictors (all < 0.001). : Although PIV was associated with mortality in patients with HFrEF, it did not independently predict outcomes beyond established risk factors. These results suggest that while inflammation may contribute to HFrEF pathophysiology, traditional clinical and biochemical markers remain more reliable for prognostication.

摘要

我们旨在研究射血分数降低的心力衰竭(HFrEF)患者的全免疫炎症值(PIV)与死亡率之间的关联,以及临床和生化参数。在这项回顾性队列研究中,分析了2014年1月至2023年12月期间诊断为HFrEF的419例患者。从机构和国家记录中收集了人口统计学特征、合并症、心脏参数[纽约心脏协会(NYHA)分级、左心室射血分数(LVEF)、心室尺寸]、药物使用情况以及实验室检查结果(PIV、N末端B型利钠肽原[NT-proBNP]、电解质和全血细胞计数)。22.91%的患者发生了死亡。PIV>696与死亡率显著相关(敏感性:37.5%,特异性:78.64%, = 0.006),但在多变量分析中它不是独立预测因素。相反,低体重指数(BMI)、收缩末期直径增加、LVEF降低、NYHA分级进展(III/IV级)、NT-proBNP升高、低钠血症和淋巴细胞减少被确定为独立预测因素(均 < 0.001)。尽管PIV与HFrEF患者的死亡率相关,但它并不能独立于既定风险因素预测预后。这些结果表明,虽然炎症可能参与HFrEF的病理生理过程,但传统的临床和生化标志物在预后评估方面仍然更可靠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ecd/12249291/173b8ddf1692/diagnostics-15-01617-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ecd/12249291/173b8ddf1692/diagnostics-15-01617-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ecd/12249291/173b8ddf1692/diagnostics-15-01617-g001.jpg

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本文引用的文献

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Association of Pan Immune-Inflammation Value with Long Term Outcomes of Acute Decompensated Heart Failure.免疫炎症整体评分与急性失代偿性心力衰竭患者长期预后的相关性研究。
Arq Bras Cardiol. 2024 Jun;121(6):e20230817. doi: 10.36660/abc.20230817.
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Myocardial Inflammation in Heart Failure With Reduced and Preserved Ejection Fraction.心力衰竭中射血分数降低和保留的心肌炎症。
Circ Res. 2024 Jun 7;134(12):1752-1766. doi: 10.1161/CIRCRESAHA.124.323659. Epub 2024 Jun 6.
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Could Pan-Immune-Inflammation Value be a Marker for the Diagnosis of Coronary Slow Flow Phenomenon?
全免疫炎症值能否成为冠状动脉慢血流现象诊断的标志物?
Cardiovasc Toxicol. 2024 May;24(5):519-526. doi: 10.1007/s12012-024-09855-4. Epub 2024 Apr 15.
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Front Immunol. 2024 Mar 28;15:1370516. doi: 10.3389/fimmu.2024.1370516. eCollection 2024.
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The prognostic impact of inflammation in patients with decompensated acute heart failure, as assessed using the pan-immune inflammation value (PIV).使用全免疫炎症值(PIV)评估失代偿性急性心力衰竭患者的炎症对预后的影响。
Scand J Clin Lab Invest. 2023 Oct;83(6):371-378. doi: 10.1080/00365513.2023.2233890. Epub 2023 Jul 11.
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A high pan-immune-inflammation value before chemoradiotherapy indicates poor outcomes in patients with small-cell lung cancer.高的 pan-immune-inflammation 值在放化疗前预示着小细胞肺癌患者预后不良。
Int J Immunopathol Pharmacol. 2023 Jan-Dec;37:3946320231187759. doi: 10.1177/03946320231187759.
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The relationship between the pan-immune-inflammation value and long-term prognoses in patients with hypertension: National Health and Nutrition Examination Study, 1999-2018.高血压患者泛免疫炎症值与长期预后的关系:1999 - 2018年美国国家健康与营养检查调查
Front Cardiovasc Med. 2023 Mar 2;10:1099427. doi: 10.3389/fcvm.2023.1099427. eCollection 2023.
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Pan-immune-inflammation value is associated with poor prognosis in patients undergoing peritoneal dialysis.全免疫炎症值与腹膜透析患者的不良预后相关。
Ren Fail. 2023 Dec;45(1):2158103. doi: 10.1080/0886022X.2022.2158103.
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Comparison of pan-immune-inflammation value with other inflammation markers of long-term survival after ST-segment elevation myocardial infarction.ST段抬高型心肌梗死后长期生存的泛免疫炎症值与其他炎症标志物的比较。
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