Hepatocyte Growth Factor and B-Type Natriuretic Peptide as Independent Predictors of Mortality in HFpEF Patients

Hou-liang Chen ¹ Xue-tao Zhu ^1* Wang Zhang ^2* Xiao-bing Cheng ^3* Ze‑ping Hu ^1*

• ¹ Department of Cardiology, The First Affiliated Hospital,, Anhui Medical University, Hefei, China
• ² Department of Pharmacy, Hefei Third Clinical College,, Anhui Medical University, Hefei, China
• ³ Department of Cardiology, Hefei Third Clinical College,, Anhui Medical University, Hefei, China

Background: Heart failure with preserved ejection fraction (HFpEF) is a common and heterogeneous syndrome with high mortality and morbidity. However, few studies have evaluated the relationship between biomarkers and subsequent outcomes in HFpEF patients. Objective: To assess the association between plasma hepatocyte growth factor (HGF) levels and all-cause mortality in HFpEF patients.Methods: This was a retrospective cohort study of 412 HFpEF patients who were hospitalized in the Department of Cardiology of the First Affiliated Hospital of Anhui Medical University from November 2020 to November 2021. The patients were divided into two groups according to the 24-month followup results: deceased (82 cases) and survivors (330 cases). The primary outcome was all-cause mortality.Multivariate logistic regression analysis was performed to identify the risk factors for all-cause mortality in HFpEF patients. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of relevant indicators for HFpEF mortality risk. Kaplan-Meier analysis was used to assess the risk of all-cause mortality in patients with increased relevant indicators. Results: Multivariate logistic regression analysis showed that HGF, B-type natriuretic peptide precursor (BNP), total protein (TP), estimated glomerular filtration rate (eGFR), and tetraiodothyronine (T4) were independent risk factors for all-cause mortality in HFpEF patients (P<0.05). ROC curve analysis showed that the optimal cut-off point of HGF was 1598 pg/mL (area under the curve [AUC]=0.645, P=0.000, hazard ratio[HR]=3.186, 95% confidence interval [CI]: 1.963-5.171), the optimal cut-off point of BNP was 271 pg/mL (AUC=0.703, P<0.000, HR=4.494, 95% CI: 2.914-6.930), and the optimal cut-off point of eGFR was 114.5 mL/min/1.73m² (AUC=0.644, P=0.423). Kaplan-Meier survival curve analysis showed that the survival probability of the patients with low HGF and BNP concentrations was significantly higher (P<0.0001), while there was no significant difference in the survival rate between the two subgroups with eGFR as the cut-off value (P=0.423). Conclusion: HGF and BNP are independent risk factors for all-cause mortality events in HFpEF patients during 24 months of follow-up, and the survival probability of HFpEF patients with low HGF and BNP concentrations is higher.