Correlation Analysis Of Heart Failure Patients With Preserved Ejection Fraction And Cystatin C,N-Terminal Pro-B-Type Natriuretic Peptide,Troponin T And Uric Acid

Objective:（1）The basic clinical data of the heart failure group with preserved ejection fraction and the normal control group were compared,so as to explore the basic clinical characteristics of heart failure patients with preserved ejection fraction.（2）To explore the clinical value of cystatin C,N-terminal Pro-B-Type Natriuretic Peptide,troponin T and uric acid in the diagnosis of heart failure patients with preserved ejection fraction.Methods:Collected patients who attended the emergency department,cardiology department and physical examination center of Guizhou Medical University Affiliated Hospital from November 2019 to March 2021.272 patients met the inclusion and exclusion criteria,including 162 patients with heart failure with preserved ejection fraction（69 males and 93 females）,and 110 cases of normal control group（60 males and 50females）.Cystatin C,N-terminal Pro-B-Type Natriuretic Peptide,troponin T,uric acid and related clinical information were completed within 24 hours,and cardiac ultrasound examination was completed within 48 hours of admission.All selected patients were in accordance with the"2018 Chinese Heart Failure Diagnosis and Treatment Guidelines"^[1].According to the cardiac function of patients,they were divided into heart failure group with preserved ejection fraction and normal control group.The basic clinical data of the two groups of patients were compared between the two groups to understand the basic clinical characteristics of heart failure patients with preserved ejection fraction.The clinical value of cystatin C,N-terminal Pro-B-Type Natriuretic Peptide,troponin T and uric acid in the diagnosis of heart failure patients with preserved ejection fraction was compared and evaluated within the group of patients with preserved ejection fraction.Results:（1）Relative to the normal control group,patients with advanced age（P<0.001）,coronary heart disease（P<0.001）,atrial fibrillation（P<0.001）,hypertension（P<0.001）occurred Heart failure with preserved ejection fraction is more likely.（2）Using the Receiver Operating Characteristic curve area under the curve cystatin C,N-terminal Pro-B-Type Natriuretic Peptide,troponin T and uric acid levels to predict the diagnosis of heart failure patients with preserved ejection f raction,using the confidence interval indicates the relative percentage,the results suggest:cystatin C AUC=0.981,95%CI:0.968～0.994,P<0.001;N-terminal Pro-B-Typ e Natriuretic Peptide AUC=0.969,95%CI:0.944～0.995,P<0.001;troponin T AUC=0.926,95%CI:0.896～0.957,P<0.001;uric acid AUC=0.837,95%CI:0.791～0.883,P<0.001).（3）Different cardiac function classification groups（a,b,c,d）in patients with heart failure with preserved ejection fraction,age,troponin T,N-terminal Pro-B-Type Natriuretic Peptide,uric acid,cystatin C,Hypertension was statistically significant（P<0.05）.Ordered Logistics regression analysis showed that cystatin C and amino acid terminal brain natriuretic peptide were statistically significant（P<0.05）,and the regression coefficient>0 indicated a positive correlation with the grade of cardiac function.Conclusions:（1）As the levels of cystatin C and N-terminal Pro-B-Type Natriuretic Peptide in the patient’s serum increase,the possibility of cardiac insufficiency is higher.（2）The combination of cystatin C,N-terminal Pro-B-Type Natriuretic Peptide,troponin T,and uric acid can improve the accuracy of predicting heart failure patients with preserved ejection fraction and help early clinical diagnosis.