Correlation Between RDW?NLR And UA And Left Ventricular Hypertrophy And Systolic Function In Elderly Patients With Chronic Heart Failure

ObjectiveTo explore Red blood cell distribution width,Neutrophil-to-Lymphocyte Ratio and uric acid and elderly chronic heart failure in patients with left Ventricular hypertrophy,systolic function correlation,predictive value and clinical application value of left ventricular hypertrophy and systolic dysfunction.MethodSelection in September 2016 to September 2018 in shenyang medical college sec--ond affiliated hospital of cardiology hospital diagnosis in elderly patients with CHF 270 cases as a group,the cases can be divided into ? grade 85 cases,? grade 103 cases,82 patients were grade ?(in accordance with the New York Heart Association of cardiac function classification);There were 157 cases of ischemic cardiomyopathy,45 cases of dilated cardiomyopathy,48 cases of hypertension and heart disease,and 20 cases of heart valve disease.Ejection fraction<50%in 141 cases,ejection fraction 50%in 129 cases.In the same period,111 healthy subjects were selected as the control group.Gender and age of all selected subjects were recorded;Height(cm)and weight(kg)were measured,and Body mass index was calculated.Blood test blood routine(including main indexes RBC?WBC?Hb?RDW and NLR),blood biochemistry(including main indexes TC?LDL-C?FPG?UA),etc.The left ventricular mass index was calculated according to the formula.General data between control group and case group were compared.The levels of RDW,NLR and UA were compared between the two groups.RDW,NLR and UA were compared between the ventricular hypertrophy group and the non-ventricular hypertrophy group.The correlation of RDW,NLR,UA,LVEDD,LVMI,and LVEF with cardiac function grading was analyzed.ROC curves were used to calculate the optimal critical value and confidence interval of RDW,NLR and UA for left ventricular hypertrophy and systolic dysfunction in elderly patients with CHF.Sensitivity and specificity were calculated.ResultsThere were no significant differences in gender,age,BMI and WBC between the control group and the case group(P>0.05).Compared with the control group,the levels of RDW,NLR,UA,LVEDD and LVMI in the elderly CHF group were significantly increased,while the levels of LVEF were significantly decreased.With the increase of cardiac function grading,the levels of RDW,NLR,UA,LVEDD and LVMI gradually increased,while the levels of LVEF decreased.Compared with the non-lvh group,both RDW and UA were increased in the LVH group,and the difference was statistically significant(P<0.05).There was no significant difference in NLR between LVH group and non-LVH group(3.61±2.11vs 3.30±1.51)(P>0.05).Correlation analysis showed that RDW was significantly positively correlated with LVEDD,LVMI and cardiac function grading,respectively(r=0.503,0.421,0.355,P<0.001).There was a significant negative correlation between RDW and LVEF(r=-0.370,P<0.001).UA was significantly positively correlated with LVEDD,LVMI and cardiac function grading,respectively(r=0.518,0.408,0.199,P<0.001).UA and LVEF were negatively correlated(r=-0.339,P<0.001).There was a significant positive correlation between NLR and cardiac function grading(r=229,P<0.05),but no correlation between NLR and LVEDD,LVMI and LVEF(P>0.05).The area under the ROC curve and the optimal critical value of RDW for ventricular hypertrophy in elderly patients with CHF were 0.703 and 13.35%,respectively.AUC and the optimal thresholds for predicting systolic dysfunction in elderly patients with CHF were 0.784 and 13.25%,respectively.The AUC and the optimal critical values of NLR in predicting ventricular hypertrophy in elderly patients with CHF were 0.602 and 2.17,respectively.AUC and the optimal thresholds for predicting systolic dysfunction in elderly patients with CHF were 0.616 and 2.11,respectively.UA predicted the AUC and the optimal critical values of ventricular hypertrophy in elderly patients with CHF were 0.700 and 358.85 mol/L,respectively.AUC and the optimal thresholds for predicting systolic dysfunction in elderly patients with CHF were 0.749 and 353.65 mol/L,respectively.It can be seen that RDW and UA have good predictive value for ventricular hypertrophy and systolic dysfunction in elderly patients with CHF,while NLR has slightly worse predictive value than RDW and UA.Conclusions1.With the gradual increase of CHF cardiac function grading in the elderly,RDW and UA gradually increased,ventricular hypertrophy increased,systolic function decreased,and ejection fraction decreased.With the deterioration of cardiac function,NLR increases gradually,and its correlation with ventricular hypertrophy and systolic function remains to be further studied.2.There was a significant positive correlation between RDW and UA and-ventricular remodeling in elderly CHF,but a significant negative correlation between RDW and UA and decreased systolic function.NLR had no significant correlation with ventricular hypertrophy and ejection fraction.3.RDW and UA were of certain reference value in predicting ventricular hypertrophy and decreased systolic function in elderly patients with chronic heart failure,while NLR was slightly worse than RDW and UA.