Prognostic value of model for end-stage liver disease excluding international normalized ratio score combined with late gadolinium enhancement in heart failure with reduced ejection fraction
- 1State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University
- 2Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College
- 3Department of Radiology, Qilu Hospital of Shandong University
Abstract
Introduction: Heart failure with reduced ejection fraction (HFrEF) is one of the main subtypes of heart failure (HF). Model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance (CMR) each independently predict adverse prognosis in HF patients.
Methods: This retrospective study enrolled adult HFrEF patients admitted to Qilu Hospital of Shandong University between September 2018 and January 2023. The primary endpoint was defined as a composite endpoint of rehospitalization for HF and all-cause mortality. Multivariate Cox regression model was established to evaluate the effects of LGE and MELD-XI score on the primary endpoint. We also evaluate the incremental prognostic value of adding the MELD-XI score to the model.
Results: A total of 246 HFrEF patients were included and 55 patients reached the primary endpoint during follow-up. In the adjusted Cox regression model, for each standard deviation increase in LGE and MELD-XI score, the hazard ratios (HRs) for primary endpoint were 1.52 (95% CI: 1.23–1.88) and 1.60 (95% CI: 1.31–1.94), respectively. Adding MELD-XI score into model improved its incremental prognostic performance [ Δ C-Statistic: 0.052 (95% CI: 0.001–0.092), p = 0.039; Continuous NRI: 0.399 (95% CI: 0.077–0.532), p = 0.027; IDI: 0.094 (95% CI: 0.018–0.174), p = 0.010].
Conclusions: Both CMR-assessed LGE and MELD-XI score were associated with adverse outcomes in patients with HFrEF. Combining these two indicators provided complementary prognostic information for HFrEF patients.
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BibTeX
@article{leng2026prognostic,
title = {{Prognostic value of model for end-stage liver disease excluding international normalized ratio score combined with late gadolinium enhancement in heart failure with reduced ejection fraction}},
author = {Linsong Leng and Shuai Zhang and Tianhao Wei and Dachuan Guo and Qian Wang and Yu Bai and Sha Chen and Chenxi Zhao and Huixia Lu and Cheng Zhang and Jianmin Yang},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = nov,
doi = {10.3389/fcvm.2026.1891852},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1891852/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prognostic value of model for end-stage liver disease excluding international normalized ratio score combined with late gadolinium enhancement in heart failure with reduced ejection fraction
AU - Linsong Leng
AU - Shuai Zhang
AU - Tianhao Wei
AU - Dachuan Guo
AU - Qian Wang
AU - Yu Bai
AU - Sha Chen
AU - Chenxi Zhao
AU - Huixia Lu
AU - Cheng Zhang
AU - Jianmin Yang
PY - 2026
DA - 2026/11/04
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1891852
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1891852/full
AB - Introduction: Heart failure with reduced ejection fraction (HFrEF) is one of the main subtypes of heart failure (HF). Model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance (CMR) each independently predict adverse prognosis in HF patients. Methods: This retrospective study enrolled adult HFrEF patients admitted to Qilu Hospital of Shandong University between September 2018 and January 2023. The primary endpoint was defined as a composite endpoint of rehospitalization for HF and all-cause mortality. Multivariate Cox regression model was established to evaluate the effects of LGE and MELD-XI score on the primary endpoint. We also evaluate the incremental prognostic value of adding the MELD-XI score to the model. Results: A total of 246 HFrEF patients were included and 55 patients reached the primary endpoint during follow-up. In the adjusted Cox regression model, for each standard deviation increase in LGE and MELD-XI score, the hazard ratios (HRs) for primary endpoint were 1.52 (95% CI: 1.23–1.88) and 1.60 (95% CI: 1.31–1.94), respectively. Adding MELD-XI score into model improved its incremental prognostic performance [ Δ C-Statistic: 0.052 (95% CI: 0.001–0.092), p = 0.039; Continuous NRI: 0.399 (95% CI: 0.077–0.532), p = 0.027; IDI: 0.094 (95% CI: 0.018–0.174), p = 0.010]. Conclusions: Both CMR-assessed LGE and MELD-XI score were associated with adverse outcomes in patients with HFrEF. Combining these two indicators provided complementary prognostic information for HFrEF patients.
SN - 2297-055X
ER -