Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction (Heart Failure February 2026)-Article: Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction

Article: Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction

Pdf Summary

This cross-sectional analysis used baseline data from 5,468 heart failure patients enrolled in the SELECT, SOUL, and FLOW trials to examine how systemic inflammation, measured by high-sensitivity C-reactive protein (hsCRP), varies across heart failure subtypes.<br /><br />Key findings:<br />- Elevated hsCRP (≥2 mg/L) was common in all heart failure groups: 52.5% in HFpEF/HFmrEF and 49.4% in HFrEF.<br />- hsCRP showed no meaningful correlation with ejection fraction.<br />- Higher hsCRP was consistently linked to being female, having obesity, diabetes, chronic kidney disease, albuminuria, COPD, and greater overall comorbidity burden.<br />- In both HFpEF/HFmrEF and HFrEF, hsCRP rose as BMI, waist circumference, and kidney disease severity increased, and as eGFR declined.<br />- Patients with more comorbidities had progressively higher hsCRP, with about a 20% increase per additional comorbidity.<br />- Coronary artery disease and prior myocardial infarction were more common among those with lower hsCRP.<br /><br />Multivariable analysis identified higher BMI, diabetes, CKD, female sex, smoking, COPD, and lower HDL as major correlates of inflammation. Importantly, the relationships between hsCRP and cardiometabolic-kidney factors were largely similar in HFpEF/HFmrEF and HFrEF, challenging the idea that inflammation is unique to preserved ejection fraction heart failure.<br /><br />The authors conclude that systemic inflammation affects roughly half of patients with heart failure and is driven mainly by obesity, kidney dysfunction, diabetes, and comorbidity burden rather than by ejection fraction subtype. These findings support further study of anti-inflammatory and cardiometabolic therapies across the full spectrum of heart failure.

Meta Tag

Concept Heart Failure

Concept Systemic Inflammation

Concept hs-CRP

Concept Left Ventricular Ejection Fraction

Concept Heart Failure with Preserved Ejection Fraction

Keywords

heart failure

systemic inflammation

hsCRP

HFpEF

HFrEF

obesity

chronic kidney disease

diabetes

comorbidity burden

cardiometabolic risk

Heart Failure

Systemic Inflammation

hs-CRP

Left Ventricular Ejection Fraction

Heart Failure with Preserved Ejection Fraction