A Study On Gender Differences In Volume Assessment Indicators For Patients With Chronic Heart Failure

Objective(s):To investigate the gender differences in volume assessment indicators,including NT-pro BNP,PVS(plasma volume status estimated based on hemoglobin and hematocrit),E/e’ ratio,and their relationship with cardiovascular adverse events during hospitalization in patients with chronic heart failure.Method(s): A total of 1,067 chronic heart failure(CHF)patients hospitalized in the Department of Cardiology at Guangxi Zhuang Autonomous Region People’s Hospital between June 1,2021,and June 1,2022,were included,consisting of 765 male and 302 female patients.After excluding patients who did not meet the inclusion criteria,487 chronic heart failure patients were ultimately included,with 347 males and 140 females.The patients were divided into two groups by gender,and their clinical data were collected.After 1:1 propensity score matching and balancing confounding factors,123 pairs were successfully matched.Based on this,the gender differences in NT-pro BNP,PVS,E/e’ levels,and adverse cardiovascular events(including cardiogenic shock,cardiac arrest,acute myocardial infarction during hospitalization,and mortality)were investigated.Finally,the gender differences in the risk factors for adverse cardiovascular events were analyzed using COX regression.Result(s):Prior to propensity score matching,all patients were divided into two groups based on sex,with 347 m mm male patients and 140 female patients,resulting in a male-to-female ratio of approximately 2.5:1.The female group had a higher prevalence of age and concurrent atrial fibrillation,while male patients with congestive heart failure(CHF)had a higher incidence of coexisting coronary heart disease(P<0.05).In female patients,levels of NT-pro BNP,PVS,EF,and E/e’ ratios were all higher than in male patients(P<0.05).The proportion of female patients with heart failure with preserved ejection fraction(HFp EF)was larger,whereas the proportion of male patients with heart failure with reduced ejection fraction(HFr EF)was higher(P<0.05).Among female HFp EF patients,NT-pro BNP,PVS,and E/e ’ratios were all higher than in male patients.Female patients experienced more severe symptoms during hospitalization and had a higher incidence of cardiogenic shock(P<0.05).No statistically significant differences were observed between males and females in terms of hospitalization duration,in-hospital adverse cardiovascular event rates,and mortality rates.In the successfully matched groups,all covariates achieved balance,and there were no statistically significant differences in age,BMI,and the prevalence of atrial fibrillation,coronary heart disease,diabetes,hypertension,and history of cerebral infarction between the groups(P>0.05).After matching,female patients still had higher levels of NT-pro BNP,PVS,E/e’ ratios,and EF values compared to male patients.Unlike with HFmr EF and HFp EF,among female HFp EF patients,NT-pro BNP,PVS,and E/e ’ratios were all higher than in male patients,suggesting that in cases of higher EF values,the severity of volume overload in women may be greater than in men.After matching,the incidence of cardiogenic shock in male patients remained higher than in female patients.COX regression analysis showed that elevated E/e’ ratios >15 and increased PVS were associated with the occurrence of in-hospital adverse cardiovascular events in both groups,and the predictive value of E/e’ratios >15 for in-hospital adverse cardiovascular events was greater in male patients.Furthermore,for each additional year of age in male patients,the risk of in-hospital adverse cardiovascular events increased by 1.081 times.Conclusion(s):1.In hospitalized patients with chronic heart failure,volume assessment indicators such as PVS,NT-pro BNP,and E/e’ ratios are higher in females,suggesting a gender difference in volume overload status.2.PVS and E/e’ elevated as risk factors for in-hospital adverse cardiovascular events.