Study Of Right Heart Structural Function In Heart Failure With Preserved Ejection Fraction And Its Correlation With Systemic Immunoinflammation Index

Objective(s):This study aimed to investigate the right heart features of heart failure with preserved ejection fraction(HFpEF).and to explore the correlation between systemic immune-inflammation index(SII)and HFpEF.Methods:From June 2021 to February 2023,52 patients with HFpEF in the Department of Cardiology of the Second Affiliated Hospital of Kunming Medical University were enrolled in the HFpEF group,and 38 patients with normal cardiac function in the same period were included as the control group,and all patients underwent echocardiography.Record the general clinical data,blood routine,blood biochemistry,N-terminal B-type natriuretic peptide(NT-pro BNP)or B-type natriuretic peptide precursor(PRO-BNP),echocardiographic parameters,etc.By collecting neutrophil,platelet,and lymphocyte values in blood cell analysis,the SII value is calculated according to the(SII = neutrophils*platelets/lymphocytes)formula.The characteristics of HFpEF right heart function and structural ultrasound indexes were discussed,and the correlation between SII value and HFpEF was discussed.Results:(1)The age of patients in the HFpEF group was older than that in the control group.(2)Compared with the control group,the SII value,urea nitrogen(BUN),blood creatinine(Cr)in the HFpEF group were higher,hemoglobin content(HGB),LYMPH,high-density leptin cholesterol(HDL-C),low-density leptin cholesterol,LDL-C)levels were lower than in the control group,The difference was statistically significant(P<0.05);(3)Compared with the control group,patients in the HFpEF group had decreased right heart function and significant right heart enlargement.Tricuspid regurgitation(TR),Systolic pulmonary artery pressure(PASP),elevated Inferior Vena cava(IVC)and Right ventricular area change fraction(RVFAC),tricuspid annular plane systolic excursion(TAPSE),decreased inferior vena cava collapse rate;RVDd base,RVDd mid,Right Ventricular End Diastolic Area(RVEDA),Right Ventricular End Systolic Area(RVESA),Right Ventricular Outflow tract diameter,(RVOTd-1,RVOTd-2,RVOTd-3),Right Atrial Diameter(RADs),Right Atrial End systolic area(RAESA),Main pulmonary artery(MPA).The difference was statistically significant(P<0.05);(4)Logistic regression analysis showed that SII(OR=4.636,95%CI:1.877-11.454,P<0.05),PASP(OR=1.015,95%CI: 1.006-1.025,P<0.05),RVDd(OR=3.927,95%CI: 1.602-9.625),RADs(OR=10.924,95%CI: 3.954-30.178)are risk factors for HFpEF.(5)According to the ROC curve analysis,the specificity of SII for the diagnosis of HFpEF was 65.8%,the sensitivity was 84.6%,the optimal cut-off value was 482.77,the area under the curve(AUC)was 0.745,and the 95%confidence interval(CI)was 0.634-0.857(P<0.001).Conclusion(s):(1)Patients in the HFpEF group had a higher SII value,and elevated SII value may be a risk factor for HFpEF.(2)The right heart function of patients in the HFpEF group decreased compared with that in the control group,accompanied by structural changes of right heart enlargement.(3)RVDd,PASP,and RADs may be predictors of HFpEF.