Clinical Value Of Arterial Blood Lactate In Evaluating Short-term Prognosis Of Patients With Acute Heart Failure

Objective: To investigate the predictive value of arterial blood lactate levels in the short-term prognosis of patients with acute heart failure.Methods:A total of 110 hospitalized patients diagnosed with acute heart failure in the hospital from August 2019 to January 2020 were selected for a 30-day follow-up.The endpoint event was defined as re-admission to the hospital due to heart failure or cardiovascular Disease-related deaths,and the patients were divided into the event group of 13 cases and the non-event group of 93 cases based on whether the endpoint event occurred.Arterial blood lactate,BNP and other indicators of the patients at admission were measured and their relationship with the short-term prognosis of patients with AHF was analyzed.Result:Of the 110 patients enrolled,13 reached end point and 97 in stable condition during follow-up.The arterial blood lactate and BNP in the event group of AHF patients within 30 days were significantly higher than that in the non-event group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that arterial blood lactate and BNP had independent predictive value for the 30-day end event of AHF patients,OR values were 6.959 and 1.001,the area under the curve of the ROC(AUC)was 0.859 and 0.905,the area under the curve of lactate combined with BNP was 0.960.The optimal cutoff value of arterial blood lactate is 1.94mmol/L,its sensitivity is 84.6%,and its specificity is 75.5%,the optimal cutoff value of BNP is 1545mmol/L,its sensitivity is92.4%,and its specificity is 74.2%.According to the optimal cutoff value of arterial blood lactate,the Kaplan-Meier survival curve is drawn,and it is found that the cumulative survival rate of the high lactate level group(lactic acid>1.94mmol/L)during the 30-day follow-up period was lower than that of the low lactate level group(lactic acid <1.94mmol/L)(P<0.05).Conclusion:The arterial blood lactate level is an independent predictor of 30-day cardiovascular events in AHF patients,and combined with BNP can improve its predictive value,the best cut-off value is 1.94mmol/L.The short-term prognosis of AHF patients can be assessed based on the arterial blood lactate level at admission.