Abstract: Objective To analyze the relationship between serum albumin level and the degree of heart function failure in patients with dilated cardiomyopathy and its value in prediction of risk of sudden death. Methods A total of 216 patients with dilated cardiomyopathy were selected as research objects, and were divided into Ⅰ to Ⅱ grading group(n=124)and Ⅲ to Ⅳ grading group(n=92)grading of cardiac function of New York Heart Association(NYHA). The general data and serum albumin levels of the two groups were analyzed. The related factors were analyzed by Pearson correlation analysis, the patients were followed up for 24 months, and the incidence rate of sudden death was observed. Multivariate Logistic regression was performed to analyze the independent predictive factors of sudden death. Area under the curve(AUC)of the receiver's working characteristics(ROC)was used to quantitatively evaluate the efficacy of serum albumin levels in prediction of the risk of sudden death. Results There were significant differences in the left atrial inner diameter, left ventricular end-diastolic inner diameter, left ventricular ejection fraction and serum albumin level between two groups(P<0.05 or P<0.01). Pearson correlation analysis showed that serum albumin levels in patients with dilated cardiomyopathy were negatively correlated with the left atrium diameter and the left ventricular end-diastolic diameter(r=-0.384, -0.457, P<0.001), and were positively - correlated with the left ventricular ejection fraction(r=0.518, P<0.001). All patients were followed up successfully, and a total of 46 sudden death cases were found. Logistic multivariate regression analysis showed that left ventricular ejection fraction and serum albumin were independent predictors of sudden death in patients with dilated cardiomyopathy(P<0.05); ROC curve analysis showed that AUC of serum albumin in prediction of sudden death in patients with dilated cardiomyopathy was 0.924, which was significantly higher than 0.738 of left ventricular ejection fraction, the difference was statistically significant(P<0.05). Conclusion Serum albumin level is negatively correlated with degree of heart function failure in patients with dilated cardiomyopathy, and has higher effectiveness in predicting the risk of sudden death.