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Corresponding author: fengyanhong, 13704067100@163.com

DOI: 10.12201/bmr.202512.00047

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  Abstract: Objective To explore the value of ultrasound automatic strain technique parameters in the diagnosis of heart failure with preserved ejection fraction (HFpEF), and to construct a nomogram diagnostic model integrating clinical indicators, conventional ultrasound parameters and automatic strain parameters, in order to improve the accuracy of early diagnosis of HFpEF.Methods Jinzhou Medical University from March 2024 to June 2025 were selected. Among them, 216 patients diagnosed with heart failure with preserved ejection fraction (HFpEF) based on high scores of H2FPEF and HFA-PEFF were included in the experimental group, while 97 patients with risk factors but without HFpEF were assigned to the control group. All patients general clinical data, conventional echocardiographic parameters, and parameters such as global longitudinal strain (GLS) of the left ventricle obtained by automatic strain technology were collected.Results Univariate and multivariate Logistic regression were used to determine independent influencing factors and construct a nomogram model. On this basis, the model performance was evaluated by drawing ROC curves, calibration curves, decision curves, and clinical impact curves.Results: The final model includes 7 variables: NT-proBNP (OR = 19.133, 95% CI = 10.119 - 36.179, P < 0.001), E/e ratio (OR = 5.533, 95% CI = 3.292 - 9.301, P < 0.001), LVGLS (OR = 4.504, 95% CI = 2.552 - 7.949, P < 0.001), LVAP2LS (OR = 3.431, 95% CI = 2.074 - 5.677, P < 0.001), LVAP3LS (OR = 4.602, 95% CI = 2.762 - 7.67, P < 0.001), LVAP4LS (OR = 5.505, 95% CI = 2.944 - 10.295, P < 0.001), and LASr (OR = 3.041, 95% CI = 1.853 - 4.993, P < 0.001). The area under the ROC curve (AUC) of the training set was 0.972 (95% CI = 0.954 - 0.989), and the AUC of the test set was 0.967 (95% CI = 0.936 - 0.997). The Hosmer-Lemeshow test showed no statistical difference between the predicted and actual clinical probabilities (training set P = 0.933, test set P = 0.766), and the calibration curve also indicated a good fit of the model. Additionally, the decision curve analysis revealed that the model could achieve net benefits across the entire threshold probability range, indicating that the model has good clinical utility.Conclusion Based on the core parameters of the ultrasonic automatic strain technology, and combined with clinical and conventional ultrasound indicators, the diagnostic model constructed by the nomogram has good diagnostic efficacy for HFpEF. It can be used as an effective visual tool to assist clinicians in individualized diagnosis of HFpEF, improve the early recognition rate, and thereby enhance the management and prognosis of patients.

  Key words: Ejection fraction retention heart failure; Automatic strain technology; Prediction model: Nomogram

  Submit time: 16 December 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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