Beyond hemodynamics: LVEF as a master regulator of the systemic inflammatory response
E Chuquiure-Valenzuela, F Gonzalez-Mayo, E Silva-Mauricio, F Bejarano-Vergara, G Martinez-Gonzalez, R Garduno-Correa, A Mendoza-Cortez, M Tapia-Sansores, A Perez-Falcon, K Bautista-Hernandez, R Lozano-Corral, V Flores-Gutierrez, C Vargas-De LeonAbstract
Introduction
C-reactive protein (CRP) is a key biomarker linked to ventricular remodeling and cardiac dysfunction; however, the quantitative relationship between the magnitude of systemic inflammation and left ventricular ejection fraction (LVEF) requires further clinical precision.
Objective
To evaluate the association between CRP levels and LVEF in a cohort of hospitalized patients with heart failure (HF).
Material and Method
A retrospective cohort study (2021–2023) was conducted in patients with cardiovascular diagnoses. We collected sociodemographic data, echocardiographic parameters (LVEF), and high-sensitivity CRP (hs-CRP) levels at the time of admission. Inflammatory status was categorized into lower and higher CRP levels using the 50th percentile as the cut-off point. Spearman correlation and logistic regression models were employed, with statistical significance set at p < 0.05.
Results
The study population presented a mean LVEF of 48.9 ± 14.5% and a median CRP of 11.25 mg/L. A significant inverse correlation was identified (rho = -0.187, p = 0.011). Patients with LVEF <30% showed a high CRP prevalence of 67.9%, compared to 40.9% in those with preserved or mid-range LVEF. Logistic regression confirmed that for every 10% increase in LVEF, the risk of systemic inflammation decreases by 20.3% (OR 0.797; 95% CI 0.65–0.98; p = 0.032).
Conclusions
These results demonstrate an independent and statistically significant inverse association between ejection fraction and the magnitude of the systemic inflammatory state. The finding that the risk of elevated inflammation is reduced by 20% for every 10% increment in LVEF suggests that mechanical ventricular dysfunction is a critical determinant of residual inflammatory activity. These data underscore the importance of CRP as a dynamic risk biomarker and suggest that optimizing systolic function may be a strategy to modulate the systemic inflammatory response in patients with heart disease.Proportion of CPR-hs according LVEFFor image description, please refer to the figure legend and surrounding text.