Correlation Analysis Between Triglyceride Glucose Index And Heart Failure With Preserved Ejection Fraction

Objective:To explore the correlation between TyG index and disease severity and prognosis in patients with heart failure with preserved ejection fraction(HFpEF),improve the risk factors of HFpEF,evaluate the clinical significance of TyG index level in patients with HFpEF,and provide new targets and ideas for the treatment of HFpEF.Methods:According to the inclusion criteria,hospitalized patients with symptoms of heart failure in the Department of Cardiology of Jinan Central Hospital from January 1,2019 to December 31,2021 were selected.Finally,199 HFpEF patients were included in the HFpef group and 100 patients were included in the control group.According to New York Heart Association(NYHA)classification,the HFpEF group was further divided into class Ⅱ(n=65),class Ⅲ(n=68)and class Ⅳ(n=66).According to the occurrence of adverse events such as readmission for heart failure.cardiovascular death,and all-cause death during the one-year follow-up,the patients were divided into the good prognosis group(n=105)and the poor prognosis group(n=94).(1)The basic clinical data,related laboratory data and echocardiographic data of enrolled patients were collected.(2)Statistical analysis software SPSS 25.0 was used to analyze the relevant data of the included patients.Spearman correlation analysis was used to explore the correlation between hypertension,atrial fibrillation,age,BMI,systolic blood pressure,uric acid,CysC,TyG index,NT-proBNP level and HFpEF,and TyG index level with hypertension,atrial fibrillation,age,BMI,systolic blood pressure,uric acid,CysC,NT-proBNP level and ultrasound Correlation of cardiac parameters.Binary logistic regression analysis was used to screen out the risk factors for the occurrence and prognosis of HFpEF.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of TyG index for HFpEF.Results:(1)The age,systolic blood pressure,BMI,prevalence of hypertension and atrial fibrillation,levels of uric acid,CysC,TyG index,NT-proBNP and echocardiographic parameters of left ventricular posterior wall thickness,interventricular septal thickness and left ventricular mass index in HFpEF group were higher than those in control group,and left ventricular end-diastolic diameter was lower than that in control group.The difference was statistically significant(p<0.05).(2)TyG index and NT-proBNP levels increased with the increase of heart function classification,and the difference was statistically significant(p<0.05).(3)The age,prevalence of hypertension and TyG index in the poor prognosis group were higher than those in the good prognosis group(p<0.05).(4)Correlation analysis:①Spearman correlation analysis was used to analyze the correlation between hypertension,atrial fibrillation,age,BMI,systolic blood pressure,uric acid,CysC,TyG index,NT-proBNP and HFpEF.The results showed that hypertension,atrial fibrillation,age,BMI,systolic blood pressure,uric acid,CysC,TyG index and NT-proBNP levels were positively correlated with HFpEF(r>0,p<0.05).②The correlation between TyG index and hypertension,atrial fibrillation,age,BMI,systolic blood pressure,uric acid,CysC,NT-proBNP levels in HFpEF group and control group were analyzed.TyG index level was positively correlated with NT-proBNP level in HFpEF group and control group(r>0,p<0.05).③The correlation between TyG index and echocardiographic parameters in HFpEF group and control group was analyzed.TyG index was negatively correlated with Left ventricular end-diastolic diameter(LVDd)in HFpEF group(r<0,p<0.05),but not in control group(P>0.05).④TyG index was positively correlated with cardiac function classification and prognosis in HFpEF patients(r<0,p<0.05).(5)Multivariate regression analysis of related influencing factors:①Logistic binary regression analysis showed that age,atrial fibrillation,systolic blood pressure,BMI,TyG index and NTproBNP were all independent risk factors for HFpEF(OR>1).Among them,the OR value of TyG index was the largest,and its regression coefficient was 2.489,OR value was 12.049,and the 95%confidence interval of OR value was 2.063-70.359.②Logistic binary regression analysis was used to analyze the risk factors of adverse events,and the results showed that TyG index was an independent risk factor for adverse events in HFpEF(OR>1).The regression coefficient of it with the occurrence of adverse prognostic events was 1.439,the OR value was 4.215,and the 95%confidence interval of OR value was 2.070-8.582.(6)Kaplan-Meier survival analysis:the median of TyG index in HFpEF group was 8.997,and TyG index ≤8.997 was defined as group 1,and TyG index>8.997 was defined as group 2.Kaplan-Meier survival analysis was performed on HFpEF patients.The cumulative incidence of adverse events in group 2 was significantly higher than that in group 1(49.00%vs 34.45%,χ2=9.037,p=0.003).(7)The predictive value of TyG index for HFpEF:according to the ROC curve,the area under the curve of TyG index for predicting HFpEF was 0.859(95CI%:0.818-0.899,p<0.05),the Cut-off value was 8.75,the sensitivity was 68.9%,and the specificity was 92%.The AUC of TyG index combined with NT-proBNP in the diagnosis of HFpEF was 0.914(95CI%:0.882-0.945,p<0.05),the Cut-off value was 0.37,the sensitivity was 82.4%,and the specificity was 89%.TyG index combined with NT-proBNP can increase the diagnostic efficacy of HFpEF.Conclusions:(1)High TyG index is an independent risk factor for HFpEF and positively correlated with the severity of the disease.(2)HFpEF patients with high TyG index have a higher risk of adverse prognostic events,which can help to judge the prognosis of HFpEF patients.