| BackgroundHeart failure is the end stage of the development of various cardiovascular diseases.Early diagnosis and grading the risk level of heart failure patients play an important role in their treatment plan and prognosis guidance,which is crucial to improve the prognosis and reduce the mortality of heart failure patients.At present,the classification of heart failure patients in clinical work is mainly based on their cardiac function parameters.Currently,medical devices and technologies such as ultrasound and magnetic resonance imaging are able to reflect the current structure and function of the patient’s heart in a more intuitive and objective way.In clinical work,we have observed that patients with heart failure who are positive for cardiac delay enhancement tend to have a poor prognosis.Previous studies on delayed enhancement imaging focused on the significance of diagnosis and prognosis of cardiomyopathy,and few studies were conducted on the prognostic value of comprehensive indicators in the prognosis of patients with heart failure,which still needs further research.ObjectiveThe purpose of this study was to investigate the value of serological combined with imaging indices for clinical application in patients with heart failure by combining serological indices and multimodal imaging index performance to predict the likelihood of adverse events in heart failure patients.Further grading of the risk level of heart failure patients will enable accurate and effective identification of high-risk heart failure patients for early intervention in clinical work,thereby delaying life expectancy.MethodsA total of 138 patients who visited the Second Hospital of Jilin University from November 2020 to November 2022 and underwent cardiac MRI were selected,and the general data of the patients were collected and the related laboratory laboratory indexes were perfected;LVEF,LVFS,LVEDV,and LVESV levels were measured and calculated by cardiac MRI,after which the follow-up results were used to combine.After that,a prediction model for poor prognosis of heart failure patients was established by combining multiple indicators with follow-up results.The data analysis was performed with SPSS 26.0 statistical software.Results1.The levels of NT-pro BNP and troponin in patients with heart failure were higher than those in the control group;The proportion of patients with decreased first pass perfusion and late gadolinium enhancement in the heart failure group was higher than that in the normal heart function group,with a statistically significant difference;Taking the above-mentioned NT-pro BNP,troponin,first-pass perfusion reduction and late gadolinium enhancement as the independent variable X,and taking the occurrence of heart failure as the dependent variable Y,a logistic regression analysis was constructed.It was found that late gadolinium enhancement and NT-pro BNP were independent influential factors related to heart failure(P<0.05).The probability of heart failure in patients with late gadolinium enhancement was 2.974 times that in patients without late gadolinium enhancement.Spearman correlation analysis of left ventricular function parameters and late gadolinium enhancement showed that LVEF(R=-0.22,P<0.05)was negatively correlated with late gadolinium enhancement,LVESV(R=0.20,P<0.05)was positively correlated with late gadolinium enhancement.The correlation between LVFS/LVEDV and late gadolinium enhancement was not statistically significant.2.The statistically significant difference index in general data was used as the independent variable X,and whether patients had late gadolinium enhancement was used as the dependent variable Y.The binary logistic regression analysis model affecting the late gadolinium enhancement outcome was constructed.From the logistic regression,it can be learned that first-pass perfusion,EDVi,and ESVi may be the risk factors affecting late gadolinium enhancement,among which first-pass perfusion is the strongest risk factor for the occurrence of late gadolinium enhancement,and the probability of late gadolinium enhancement in patients with reduced first-pass perfusion is 26.74 times higher than that in patients with normal first-pass perfusion.3.Late gadolinium enhancement was a risk factor for poor prognosis in heart failure patients;EF value and lymphocyte count were negatively correlated with the probability of poor prognosis in heart failure patients and were protective factors for poor outcome in heart failure patients;red blood cell distribution width and neutrophil-to-lymphocyte ratio were risk factors for poor prognosis in heart failure patients,and RDW and NLR were positively correlated with the probability of MACE events in heart failure patients;among them late gadolinium enhancement was a strong predictor,and the probability of MACE events in heart failure patients with positive late gadolinium enhancement was 5.565 times higher than that in patients with negative delayed intensification.The ROC curve was plotted according to the predictive value of the equation,and the predictive model had a maximum value of0.707 for the Yordon index when its optimal cutoff value was taken,at which time the model had the highest sensitivity of 88.5% and specificity of 82.2%.Conclusion1.Late gadolinium enhancement may be related to the occurrence of heart failure,and patients with late gadolinium enhancement are more prone to heart failure..2.EDVi,ESVi and Microcirculatory impairment suggested by reduced first-pass perfusion are associated with delayed onset of enhancement,and these indicators may be related to myocardial fiber manifestations.3.The likelihood of adverse events in patients with heart failure was predicted by serology combined with multimodal imaging indexes.Among them,late gadolinium enhancement,red blood cell distribution width,and neutrophil count to lymphocyte count ratio were risk factors for poor prognosis in heart failure patients;high left ventricular ejection fraction and lymphocyte count were protective factors for poor prognosis in heart failure patients. |
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