Clinical diagnostic value of NT-proBNP and triglyceride-glucose index combined ith echocardiographic parameters in elderly patients with heart failure

doi:10.3969/j.issn.1004-583X.2025.06.003

Abstract

Abstract:

Objective To investigate the diagnostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and triglyceride-glucose (TyG) index combined with transthoracic echocardiography (TTE) parameters in elderly heart failure (HF), and to analyze their independent influencing factors. Methods A retrospective case-control study was conducted, including 99 elderly HF patients (observation group) and 86 healthy controls (control group) aged 60-90 years admitted from February to December 2024. Baseline data, laboratory indicators (NT-proBNP, triglycerides, fasting blood glucose), and TTE parameters (left ventricular ejection fraction [LVEF], left atrial diameter [LAD], left ventricular end-diastolic diameter [LVEDD], and others) were collected. Multivariate Logistic regression identified independent risk factors for HF, and receiver operating characteristic (ROC) curves evaluated the diagnostic performance of individual and combined models. Results The observation group showed significantly higher rates of diabetes (40.4% vs 10.5%), coronary heart disease (90.9% vs 72.1%), NT-proBNP (2825.00 vs 205.45 pg/ml), TyG index (8.68 vs 8.28), triglycerides (1.17 vs 0.97 mmol/L), fasting blood glucose (6.29 vs 5.33 mmol/L), LVEDD (50.10 vs 44.13 mm), left ventricular end-systolic diameter (36.30 vs 30.40 mm), LAD (43.71 vs 35.94 mm), left ventricular end-diastolic volume (117.90 vs 102.0 ml), and left ventricular end-systolic volume (55.50 vs 36.55 ml) compared to the control group (all P<0.05). LVEF was significantly lower in the observation group than in the control group (52.20% vs 63.80%, P<0.05). Multivariate analysis identified that NT-proBNP (OR=1.000, 95%CI: 1.000-1.001), TyG index (OR=12.711, 95%CI: 4.034-40.047), and LAD (OR=1.143, 95%CI: 1.053-1.241) were independent risk factors for HF, while LVEF (OR=0.929, 95%CI: 0.881-0.980) was an independent protective factor (all P<0.05). The combined model (NT-proBNP+TyG+TTE) achieved an area under the curve (AUC) of 0.932(95%CI: 0.899-0.966), surpassing that of an individual indicator (NT-proBNP: 0.882; TyG: 0.749; TTE: 0.868) and dual-indicator models (NT-proBNP+TTE: 0.903)(all P<0.05). Hosmer-Lemeshow test indicated good model fit (P>0.05). Conclusion The combination of NT-proBNP, TyG index, and TTE parameters demonstrates strong diagnostic efficacy for elderly HF. Elevated NT-proBNP, TyG index, increased LAD, and reduced LVEF are independent predictors of HF.

Key words: heart failure, N-terminal pro-B-type natriuretic peptide, triglyceride-glucose index, transthoracic echocardiography

CLC Number:

R541.62

Cao Lihui, Huo Xianghui. Clinical diagnostic value of NT-proBNP and triglyceride-glucose index combined ith echocardiographic parameters in elderly patients with heart failure[J]. Clinical Focus, 2025, 40(6): 498-503.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.06.003

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Figures/Tables 6

References 21

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组别	例数		性别[例(%)]			年龄 (岁)		体重指数 (kg/m²)		高血压史 [例(%)]		糖尿病史 [例(%)]			冠心病史 [例(%)]
组别	例数		男	女		年龄 (岁)		体重指数 (kg/m²)		高血压史 [例(%)]		糖尿病史 [例(%)]			冠心病史 [例(%)]
对照组	86		45(52.3)	41(47.7)		72.50(67.00,79.00)		25.11±3.33		56(65.1)		9(10.5)			62(72.1)
观察组	99		49(49.5)	50(50.5)		74.00(71.00,81.00)		25.77±3.44		61(61.6)		40(40.4)			90(90.9)
统计值			χ²=0.148			Z=-1.935		t=-1.322		χ²=0.243		χ²=21.190			χ²=11.120
P值			0.701			0.053		0.188		0.649		<0.001			0.001
组别	NT-proBNP (pg/ml)				甘油三酯 (mmol/L)		空腹血糖 (mmol/L)		TyG指数		LVEF (%)			LVEDD (mm)
对照组	205.45(61.01, 498.28)				0.97(0.75, 1.28)		5.33(4.81, 5.88)		8.28(8.04, 8.63)		63.80(60.98, 66.80)			44.13(40.94, 46.75)
观察组	2825.00(958.00, 7997.00)				1.17(0.93, 1.46)		6.29(5.31, 8.72)		8.68(8.40, 9.18)		52.20(43.90, 61.50)			50.10(45.40, 57.10)
统计值	Z=-8.963				Z=-3.243		Z=-5.467		Z=-5.836		Z=-7.335			Z=-3.627
P值	<0.001				0.001		<0.001		<0.001		<0.001			<0.001
组别		LVESD(mm)			LAD(mm)		EDV(ml)			ESV(ml)			SV(ml)
对照组		30.40(28.23,32.03)			35.94±4.32		102.00(88.60,117.32)			36.55(30.53,41.60)			64.90(56.35,72.70)
观察组		36.30(31.00,43.40)			43.71±7.78		117.90(94.40,160.00)			55.50(39.10,84.90)			63.00(52.30,77.60)
统计值		Z=-5.892			t=-8.239		Z=-3.470			Z=-5.924			Z=-0.673
P值		<0.001			<0.001		<0.001			<0.001			0.502

组别	例数		性别[例(%)]			年龄 (岁)		体重指数 (kg/m²)		高血压史 [例(%)]		糖尿病史 [例(%)]			冠心病史 [例(%)]
组别	例数		男	女		年龄 (岁)		体重指数 (kg/m²)		高血压史 [例(%)]		糖尿病史 [例(%)]			冠心病史 [例(%)]
对照组	86		45(52.3)	41(47.7)		72.50(67.00,79.00)		25.11±3.33		56(65.1)		9(10.5)			62(72.1)
观察组	99		49(49.5)	50(50.5)		74.00(71.00,81.00)		25.77±3.44		61(61.6)		40(40.4)			90(90.9)
统计值			χ²=0.148			Z=-1.935		t=-1.322		χ²=0.243		χ²=21.190			χ²=11.120
P值			0.701			0.053		0.188		0.649		<0.001			0.001
组别	NT-proBNP (pg/ml)				甘油三酯 (mmol/L)		空腹血糖 (mmol/L)		TyG指数		LVEF (%)			LVEDD (mm)
对照组	205.45(61.01, 498.28)				0.97(0.75, 1.28)		5.33(4.81, 5.88)		8.28(8.04, 8.63)		63.80(60.98, 66.80)			44.13(40.94, 46.75)
观察组	2825.00(958.00, 7997.00)				1.17(0.93, 1.46)		6.29(5.31, 8.72)		8.68(8.40, 9.18)		52.20(43.90, 61.50)			50.10(45.40, 57.10)
统计值	Z=-8.963				Z=-3.243		Z=-5.467		Z=-5.836		Z=-7.335			Z=-3.627
P值	<0.001				0.001		<0.001		<0.001		<0.001			<0.001
组别		LVESD(mm)			LAD(mm)		EDV(ml)			ESV(ml)			SV(ml)
对照组		30.40(28.23,32.03)			35.94±4.32		102.00(88.60,117.32)			36.55(30.53,41.60)			64.90(56.35,72.70)
观察组		36.30(31.00,43.40)			43.71±7.78		117.90(94.40,160.00)			55.50(39.10,84.90)			63.00(52.30,77.60)
统计值		Z=-5.892			t=-8.239		Z=-3.470			Z=-5.924			Z=-0.673
P值		<0.001			<0.001		<0.001			<0.001			0.502

参数	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
参数	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
NT-proBNP	0.001	0.000	23.837	<0.001	1.001	1.000	1.001
TyG指数	2.026	0.387	27.396	<0.001	7.583	3.551	16.193
LVEF	-0.136	0.024	33.108	<0.001	0.873	0.834	0.914
LAD	0.222	0.036	38.283	<0.001	1.249	1.164	1.340

参数	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
参数	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
NT-proBNP	0.001	0.000	23.837	<0.001	1.001	1.000	1.001
TyG指数	2.026	0.387	27.396	<0.001	7.583	3.551	16.193
LVEF	-0.136	0.024	33.108	<0.001	0.873	0.834	0.914
LAD	0.222	0.036	38.283	<0.001	1.249	1.164	1.340

参数	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
参数	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
NT-proBNP	0.000	0.000	8.317	0.004	1.000	1.000	1.001
TyG指数	2.542	0.586	18.854	<0.001	12.711	4.034	40.047
LVEF	-0.074	0.027	7.273	0.007	0.929	0.881	0.980
LAD	0.134	0.042	10.201	0.001	1.143	1.053	1.241