Blood Biomarkers Combined With Imaging Parameters for Prognostic Assessment in Patients With Different Types of Heart Failure: A Retrospective Single-Center Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 4,000
- 主要终点
- All-cause mortality
研究概览
简要总结
This study aims to develop a better model to predict one-year risk of death in patients with heart failure. We will test whether combining information from routine blood tests (like NT-proBNP) and heart scans (measuring features like epicardial fat density) improves risk prediction compared to using either type of data alone.
This is a retrospective study using existing medical records of patients treated for chronic heart failure at Xinjiang Medical University First Affiliated Hospital between 2012 and 2024. No new patient contact or interventions are involved.
The goal is to enable more accurate, personalized risk assessment across different types of heart failure (HFrEF, HFmrEF, HFpEF).
详细描述
Background and Rationale:
Accurate prognosis in heart failure (HF) remains challenging due to phenotypic heterogeneity across the spectrum of left ventricular ejection fraction (LVEF). While biomarkers like N-terminal pro-B-type natriuretic peptide (NT-proBNP) and imaging parameters like LVEF are standard prognostic tools, each has limitations. Emerging imaging parameters, such as epicardial adipose tissue (EAT) density (reflecting fat inflammation/fibrosis) and left ventricular global longitudinal strain (LVGLS), offer potential incremental prognostic value but are not yet integrated into routine clinical models. This study aims to systematically evaluate whether a multi-parameter model combining established blood biomarkers and advanced imaging metrics improves the prognostic stratification of patients with HFrEF, HFmrEF, and HFpEF compared to traditional approaches.
Detailed Methodology:
This is a single-center, retrospective cohort study. The study population consists of consecutive adult patients (≥18 years) with a confirmed diagnosis of chronic HF who had both qualifying blood biomarker assessment (NT-proBNP and/or high-sensitivity cardiac troponin) and cardiac imaging (transthoracic echocardiography and/or cardiac computed tomography) performed within a ±3-month window around an index encounter between January 1, 2012, and December 31, 2024, at Xinjiang Medical University First Affiliated Hospital.
Key data to be extracted from electronic health records include: 1) Clinical variables: demographics, comorbidities (e.g., ischemic etiology, diabetes, hypertension), medications, and NYHA class; 2) Blood biomarkers: NT-proBNP, hs-cTnT/I, hs-CRP, and renal function (eGFR); 3) Imaging parameters: LVEF, LVGLS, left atrial volume index (LAVI), E/e' ratio, and EAT volume/density (from CT, if available).
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years.
- •Confirmed diagnosis of chronic heart failure.
- •Treated at the study center between January 1, 2012, and December 31,
- •Availability of both qualifying blood biomarker test results (NT-proBNP and/or high-sensitivity cardiac troponin) and cardiac imaging (echocardiography and/or cardiac CT) performed within a ±3-month window around the index encounter.
排除标准
- •Heart failure primarily due to severe primary valvular disease, acute myocardial infarction, myocarditis, or pulmonary embolism.
- •End-stage renal disease requiring dialysis.
- •Clinical records or follow-up data are severely incomplete, precluding outcome assessment.
研究组 & 干预措施
Heart Failure Cohort
Adult patients (≥18 years) with a confirmed diagnosis of chronic heart failure who had both qualifying blood biomarker assessment and cardiac imaging performed within a specified window at the study center between 2012 and 2024.
This is an observational cohort. No specific intervention is administered or withheld as part of the research protocol.
结局指标
主要结局
All-cause mortality
时间窗: 1 year
Occurrence of death from any cause within one year (365 days) from the index date. The index date is defined as the date of the first qualifying encounter that meets all inclusion criteria.
次要结局
- Phenotype-specific prognostic performance(1 year)
- Independent prognostic value of EAT density in HFpEF(1 year)
- Occurrence of HFimpEF(Through study completion,up to 13 years.)
- Association between baseline NT-proBNP level and HFimpEF(Through study completion, up to 13 years.)
- Association between baseline EAT density and HFimpEF(Through study completion, up to 13 years.)
研究者
Xiang Xie
Professor
Xinjiang Medical University