To Estimate High Density Lipoprotein Cholesterol/hs-C Reactive Protein Ratio in Heart Failure with Preserved Ejection Fraction (HFpEF)

Background: Heart Failure with preserved ejection fraction (HFpEF) represents approximately 50% of heart failure cases and poses unique diagnostic and therapeutic challenges. Inflammation plays a crucial role in HFpEF pathogenesis, but reliable biomarkers remain limited. This study evaluates the relationship between HDL-C/hs-CRP ratio and cardiac function in HFpEF patients. Methods: A hospital-based cross-sectional study enrolled 113 patients with HFpEF (EF≥50%) at J.L.N Hospital, Ajmer from December 2022 to November 2023. We measured HDL-C and hs-CRP levels and correlated their ratio with comprehensive echocardiographic parameters including LVEF, LAV, and TAPSE, following standardized protocols. Results: Our study analyzed 113 patients with HFpEF, with males comprising 63.7% of the population. Age distribution showed predominance in the 51-60 years group (36.3%), followed by 41-50 years (31.0%). Major risk factors included hypertension (67.26%), alcoholism (54.87%), and diabetes (46.90%). Dyspnea was the most common presenting symptom (86.7%), with basal lung crepitations being the predominant sign (92.04%). Laboratory findings revealed median hs-CRP of 3.2 mg/dl (IQR: 2.5-4.1) with 54.87% patients showing moderate elevation (1-3 mg/dl). HDL levels were predominantly low, with median 34 mg/dl (IQR: 29-47) and 68.14% patients in 30-39 mg/dl range. Mean HDL-C/hs-CRP ratio was 4.31±0.96. Echocardiographic assessment showed preserved systolic function (median LVEF 59%, IQR: 56-67%) with evidence of diastolic dysfunction (E/e’ median 15, IQR: 13-22). Multiple regression analysis demonstrated significant correlations between HDL-C/hs-CRP ratio and cardiac function parameters: LVEF (β=-0.087, p=0.048), LAV & LVMI index (β=-0.081, p=0.032), and TAPSE (β=0.079, p=0.041). NYHA classification revealed predominantly advanced disease with 87.61% patients in Class III/IV. Conclusion: The HDL-C/hs-CRP ratio demonstrates significant correlation with cardiac function parameters in HFpEF patients, suggesting its potential as a novel prognostic marker.