The association between cardiac function status and prognosis in patients with diabetic foot ulcers
10.3760/cma.j.cn311282-20250228-00108
- VernacularTitle:糖尿病足溃疡时心功能状态及其转归与患者的预后相关
- Author:
Qiong HONG
1
;
Min LI
;
Jie YANG
;
Jianyuan SHI
;
Junyi GU
;
Huili CAI
;
Jianmin LIU
;
Zhengyi TANG
Author Information
1. 上海交通大学医学院附属瑞金医院内分泌代谢病科，远洋糖尿病足中心，上海 200025
- Publication Type:Journal Article
- Keywords:
Diabetic foot ulcer;
NYHA classification;
NT-proBNP;
Cardiac function transition;
Prognosis
- From:
Chinese Journal of Endocrinology and Metabolism
2025;41(7):540-545
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between different states of cardiac function and their changes during the course of diabetic foot ulcers(DFU), and to evaluate their impact on patient prognosis.Methods:A retrospective analysis was conducted on 194 DFU patients who were rehospitalized at approximately 3-month intervals. Basic clinical data and cardiac function-related indicators were collected at baseline and follow-up. Patients were followed until death or until November 10, 2024. Outcomes including ulcer healing, recurrence, minor amputation, and death were recorded. Logistic regression models were used to analyze the effects of cardiac function status and its changes on these four outcomes. Results:After treatment, the proportion of patients with NYHA class Ⅱ-Ⅲ decreased significantly from 33.5% at baseline to 21.6%( P=0.009). Serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) level also decreased after treatment compared with baseline [635.85(59.83, 453.28) pg/mL vs 728.67(81.48, 696.15) pg/mL, P=0.055]. Serum NT-proBNP level was significantly higher in the death group compared to the survival group( P=0.002). The proportion of DFU patients with baseline NYHA class Ⅱ-Ⅲ was significantly higher than that in those with class Ⅰ( P=0.012). Regression analysis showed that an improvement in NT-proBNP levels was associated with a lower risk of DFU recurrence( OR=0.378, 95% CI 0.183-0.779, P=0.008), and improvement in NYHA class was associated with a lower mortality risk( OR=0.074, 95% CI 0.020-0.275, P<0.001). Conclusion:Cardiac function status and its changes during the treatment of DFU patients have strong prognostic implications, particularly in predicting the risk of recurrence and death outcomes.
