The Study Of The Relationship Between Urinary Albumin Excretion Rate And Heart Failure With Preserved Ejection Fraction

ObjectiveTo investigate the relationship between Urinary Albumin Excretion Rate（UAER）and cardiac structure and function in patients with Heart Failure with Preserved ejection fraction（HFpEF）.MethodsPatients who were hospitalized in the first ward of the Department of Geriatrics of First Hospital of Lanzhou University for the symptom of heart failure from January2015 to December 2019 were selected,and the study population was selected strictly according to our inclusion and exclusion criteria.The population’s capital basic characteristics of and clinical data of patients were collected.SPSS 22.0 was used for statistical analysis.The measurement data was expressed in Mean±SD or M（Q1,Q3）.The mean between the two groups of normal distribution data was compared by Independent Sample t-Test,and Single Factor ANOVA test was used to compare multiple groups.Mann Whitney U test was used to compare the two groups of non-normal distribution data,and Kruskal Wallis H test was used to compare between multiple groups.Count data was expressed in n（%）,and Chi Square Test was used for comparison between groups.Pearson（normal distribution numerical variable）or Spearman（non-normal distribution numerical variable）correlation analysis and multiple stepwise regression were used among the factors.P<0.05 indicates that there was a statistical difference in the research results.ResultsA total of 273 patients were included in this study and divided into HFpEF group（n=218）and control group（n=55）.1.Cardiac structure:The thickness of left and right ventricles,the size of ventricle and atrium in HFPEF patients and the subgroups stratified according to the level of UAER（UAER normal group,trace group and large group）were higher than those in the control group.2.The level of E/A,E’L and E’_S in HFPEF patients and the subgroups stratified according to the level of UAER were lower than those in the control group,and the level of E/E’L,E/E’_S and E/E’were higher than those in the control group;3.UAER was positively correlated with left and right ventricular thickness,E/E’L,E/E’_S,E/E’and RAA in HFpEF patients,and was negatively correlated with the level of E’L and E’_S;4.UAER in HFpEF patients was independently associated with IVSTs,PWTs,IVSTd,LVM-AL,E’L,E’_S,E/E’,RV-FWS,PA and NT-pro BNP.Conclusion1.There were significant differences in echocardiographic indexes related to cardiac structure and function between the HFpEF patients and the control group,and the same trend can be observed in most indexes when stratified according to the level of UAER.With the increase of UAER level,there were still significant differences between HFPEF patients in different stratification groups and the control group;2.UAER was independently related to multiple parameters of left and right cardiac structural remodeling and dysfunction in patients with HFpEF,especially those parameters which were related to left cardiac structure and function;3.Clinically,for people with normal ejection fraction and suspected heart failure,as well as HFpEF patients,we should pay attention to and detect the changes of cardiac structure and function in combination with their UAER level.