Men Yi-Jiao, Dong Yan-Ling, Gong Yu, An Ya-Qing, Cheng Hong-Bo
Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
Department of Neurosurgery, The Second Hospital of Hebei Medical University, 215 Heping West Road, Shijiazhuang, 050000, China.
Sci Rep. 2025 Aug 6;15(1):28721. doi: 10.1038/s41598-025-13274-y.
Early assessment of heart failure during treatment can improve patient prognosis. Brain natriuretic peptide (BNP), uric acid (UA), pre-albumin (PA), red blood cell distribution width (RDW), and Cystatin C (Cys C) are related to the development of heart failure. This study determined whether these characteristics could serve as combined diagnostic indicators for the prognosis of New York Heart Association classification (NYHA) IV heart failure (IV-HF). Here, the general clinical and cardiac ultrasound data from 193 patients with NYHA IV-HF were collected and followed-up for six months, and their survival status was recorded. Among the patients, 119 (61.66%) survived, whereas 74 (38.34%) were reported dead at the six-month follow-up. Compared to the survival group, the death group had significantly higher age, disease duration, Cys C, UA, BNP, RDW, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and left atrial dimension, and lower PA and left ventricular ejection fraction (LVEF). Cys C, UA, BNP, and RDW had significant negative linear correlations with LVEF, while PA had a significant positive linear correlation with LVEF. In addition, high Cys C, UA, BNP, and RDW, as well as low PA, are independent risk factors for mortality in patients with IV-HF. The combination of age, disease duration, RDW, and levels of Cys C, UA, BNP, and PA can serve as diagnostic indicators for mortality in patients with NYHA IV-HF.
治疗期间对心力衰竭进行早期评估可改善患者预后。脑钠肽（BNP）、尿酸（UA）、前白蛋白（PA）、红细胞分布宽度（RDW）和胱抑素C（Cys C）与心力衰竭的发生发展有关。本研究确定这些特征是否可作为纽约心脏协会心功能分级（NYHA）IV级心力衰竭（IV-HF）预后的联合诊断指标。在此，收集了193例NYHA IV-HF患者的一般临床和心脏超声数据，并进行了为期6个月的随访，记录了他们的生存状态。在这些患者中，119例（61.66%）存活，而74例（38.34%）在6个月随访时报告死亡。与存活组相比，死亡组的年龄、病程、Cys C、UA、BNP、RDW、左心室收缩末期内径、左心室舒张末期内径和左心房内径显著更高，而PA和左心室射血分数（LVEF）更低。Cys C、UA、BNP和RDW与LVEF呈显著负线性相关，而PA与LVEF呈显著正线性相关。此外，高Cys C、UA、BNP和RDW以及低PA是IV-HF患者死亡的独立危险因素。年龄、病程、RDW以及Cys C、UA、BNP和PA水平的组合可作为NYHA IV-HF患者死亡的诊断指标。
