〔Abstract〕 Objective To explore the clinical value of monocyte count and high-density lipoprotein cholesterol ratio(MHR) in the diagnosis and treatment of chronic heart failure in patients with dilated cardiomyopathy(DCM). Methods A total of hosphospitalized 300 patients with chronic heart failure in DCM was selected and divided into NYHA Ⅱ, NYHA Ⅲ and NYHA Ⅳ group(100 patients), according to the cardiac function classification of New York Heart Association(NYHA). In the same period, 100 patients with organic heart disease and chronic heart failure were selected as the control group.The level of MHR, the relationship between MHR and N-terminal precursor B-type natriuretic peptide(NT-pro BNP), and the relationship between MHR and echocardiographic indexesrelated to cardiac remodeling and cardiac function were observed and analyzed in DCM patients with chronic heart failure. Results The MHR of DCM patients with chronic heart failure was significantly higher than that of the control group(P<0.001), and there were differences among different grades of heart failure in the case group(P<0.05). After controlling the influence of gender, it was found that MHR was positively correlated with left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD) and NT-pro BNP. It was negatively correlated with LVEF.Correlation analysis showed that MHR was positively correlated with left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD) and NT-pro BNP(P<0.05), and negatively correlated with LVEF(P<0.05). The diagnostic value of MHR combined with NT-pro BNP(AUC=0.983) was higher than that of NT-pro BNP alone(AUC=0.974)(P<0.05). These results suggested that MHR might be associated with cardiac remodeling and cardiac function in DCM.The higher the MHR, the more pronounced the cardiac remodeling of DCM, and the more severe the heart failure. The combination of MHR and NT-pro BNP might further improve the diagnostic efficacy of NT-pro BNP in chronic heart failure in DCM. Conclusion Clinically, MHR can be used as an evaluation index of the presence of chronic heart failure and the severity of HF in DCM patients. The combined measurement of MHR and NT-pro BNP may be more conducive to improve the sensitivity and specificity of the clinical diagnosis of DCM chronic HF, so as to identify and accurately implement the standardized treatment of DCM chronic HF earlier.