Urinary Albumin-to-creatinine Ratio Associated With Left Ventricular Systolic And Diastolic Function In Patients With Preserved Ejection Fraction Heart Failure

Objective: This study was to explore the correlation between Urinary albumin-tocreatinine ratio(UACR)and left ventricular systolic function and diastolic function in patients with preserved ejection fraction heart failure(HFp EF),to provide an effective and reliable evidence for the early-stage diagnosis and treatment of HFp EF.Methods: 215 subjects with HFp EF hospitalized in the cardiovascular department of An Hui provincial hospital from Oct.2017 to May.2018 were enrolled.Among them,male 109 and female 1-6,mean age 50~86(67.19±11.20).All subjects were divided into quartiles based on the level of UACR: UACR <14.5mg/g(group 1),14.5mg/g ?UACR<36.5 mg/g(group 2),36.5 mg/g?UACR<60.5 mg/g(group 3),60.5 mg/g? UACR(group 4).Compare the change of left ventricular function and indices related under different level of UACR and calculate statistic differences.To evaluate the impact of UACR on LVEF,LVEDV,LVESV,NT-pro BNP and left ventricular diastolic function.Results:(1)There were no significant differences in age,sex,heart ratio,SBP,DBP,NHYA,the prevalence of smoking,lipidemia metabolism,etiology of heart failure and medicine use in 4 quartiles(P>0.05).NT-pro BNP,LA,LVEDV and LVESV enlarged from Quartile 1 to Quartile 4 while LVEF declined(P<0.01).(2)UACR was positively associated with NT-pro BNP(r=0.697,P<0.01),LVEDV(r=0.822,P<0.01)and LVESV(r=0.859,P<0.01).Meanwhile,there was a negative correlation between UACR and LVEF(r=-0.460,P<0.01).(3)Like NT-pro BNP(AUC=0.789,95%CI 0.727~0.851,P<0.01),UACR played an important role in diagnosing left ventricular diastolic dysfunction(AUC=0.778,0.712~0.843,P<0.01).The sensitivity was 81% and specificity was 87%.(4)Left ventricular diastolic function of all subjects was divided into three types in terms of basic diastolic filling pattern: normal diastolic filling,non-restricted diastolic filling abnormality(NRDF)and restricted diastolic filling abnormality(RDF).With the growing level of UACR,the number of normal diastolic function and NRDF subjects dropped.Accordingly,the number of RDF subjects increased(P<0.05).Conclusion: In HFp EF patients,UACR is significantly related with LVEF,LVEDV,LVESV,NT-pro BNP and left ventricular diastolic dysfunction.UACR may provide evidence for evaluating early-stage cardiovascular damage.