Clinical Value of Systemic Immune Inflammation Index to Predict Left Ventricular Reverse Remodeling in Dilated Cardiomyopathy Patients With Heart Failure With Reduced Ejection Fraction
10.3969/j.issn.1000-3614.2024.07.007
- VernacularTitle:系统免疫炎症指数对扩张型心肌病合并射血分数降低的心力衰竭患者左心室逆重构的预测价值
- Author:
Mengjiao SHAO
1
;
Jia SHI
;
Huan WANG
Author Information
1. 中山大学附属第五医院 心血管病中心,珠海 519000
- Keywords:
dilated cardiomyopathy;
systemic immune inflammation index;
left ventricular reverse remodeling;
prognosis
- From:
Chinese Circulation Journal
2024;39(7):695-702
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the predictors of left ventricular reverse remodeling(LVRR)and prognosis in dilated cardiomyopathy(DCM)patients with heart failure with reduced ejection fraction(HFrEF). Methods:A total of 480 patients with HFrEF were continuously recruited.The patients were divided into LVRR group(n=235)and without LVRR group(n=245).The clinical data of patients with and without LVRR were compared.At the same time,the incidence of LVRR and complex cardiovascular adverse events in patients with different SII tripartite groups was compared.The study population was stratified according to SII tertiles:the baseline tertiles of the SII(group 1:＜332.8[n=160],group 2:332.8-563.1[n=160],and group 3:＞563.1[n=160]).Composite cardiac events include heart failure re-hospitalization,fatal arrhythmias,and cardiac death.Logistic regression analysis was used to analyze the predictive factors of LVRR.The dose-response relationship between systemic imnune inflammation index(SII)and LVRR were evaluated by restricted cubic spline(RCS).Receiver operating characteristic curves,net reclassification index(NRI),integrated discrimination improvement(IDI)and Akaike information criterion(AIC)were drawn to assess the performances of predictors to predict LVRR and prognosis.The predictive efficacy of these predictors were compared with traditional biomarkers(N-terminal pro-brain natriuretic peptide[NTpro-BNP]and soluble growth stimulation expressed gene 2 protein[sST2]).The survival analysis was performed using the Kaplan-Meier method. Results:A total of 235(49.0%)patients experienced LVRR.The results of logistic regression analysis showed that baseline SII was an independent predictor of non-LVRR(OR=1.005,95%CI:1.004～1.007,P＜0.01).RCS showed a positive linear relationship between SII and non-LVRR(Pnonlinear=0.455).Compared with traditional biomarkers NT-proBNP and sST2,ROC,NRI,IDI and AIC results proved that SII had the best predictability regarding non-LVRR.All 480 patients completed the follow-up,there were 108(22.5%)composite cardiac events and 37(7.7%)all-cause deaths.Patients in the SII＞563.1 group had higher rate of composite cardiovascular events than those in the SII＜332.8 and SII 332.8 to 563.1 groups(43.1%vs.9.4%vs.15.0%,log-rank P＜0.01). Conclusions:This study indicates that increased SII at admission could predict non-LVRR in DCM related HFrEF patients and its predictive efficacy is better than traditional biomarkers.
