Objective To investigate the effect of serum albumin on the long-term prognosis of patients with heart failure with preserved ejection fraction（HFpEF）. Methods This retrospective study included patients with HFpEF hospitalized in the Department of Cardiology

the Affiliated T.C.M Hospital of Southwest Medical University from January 2014 to February 2016. Serum albumin levels were measured within 24 h after admission

and patients were divided into low and normal serum albumin groups. The follow-up ended on February 2019

and the primary outcome event was death during the follow-up period. Univariate analysis was performed on all variables affecting the prognosis of patients

and variables with P < 0.05 were included in the Cox regression model. Multivariate Cox regression was used to evaluate the predictive value of serum albumin for the prognosis of patients with HFpEF. Kaplan-Meier analysis was performed to evaluate the relationship between serum albumin and mortality from HFpEF.Results A total of 186 patients were enrolled

including 57 in the low serum albumin group and 129 in the normal serum albumin group. The median follow-up time was 1.5 years. The survival rate was 64.71%（34 cases）in the low serum albumin group and 94.78%（115 cases）in the normal serum albumin group. Kaplan-Meier survival curves showed a significantly lower cumulative survival rate of patients in the low serum albumin group than in the normal serum albumin group（79.1% vs 52.9%

P < 0.001）. Multivariate Cox regression analysis revealed low serum prealbumin as an independent risk factor for mortality in patients with HFpEF（HR: 0.919

95% CI: 0.871 ～ 0.969

P =0.002）. Conclusion Low serum albumin is an independent predictor of poor long-term prognosis in patients with HFpEF.