摘要
目的探讨射血分数保留的心力衰竭(HFpEF)患者血清肌肉生长抑制素(Myostatin)、Delta样缺口配体1(DLL1)与心室重构指标和预后的关系。方法选取2021年1月至2022年1月该院收治的117例HFpEF患者为HFpEF组,另选取同期100例体检健康者为对照组。比较HFpEF组与对照组血清Myostatin、DLL1水平和心室重构指标[左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、左心室心肌质量指数(LVMI)]。采用Pearson相关性分析HFpEF患者血清Myostatin、DLL1与心室重构指标的相关性。根据随访1年的预后状况,将HFpEF患者分为预后不良组和预后良好组。采用多因素Logistic回归分析HFpEF患者预后不良的影响因素,受试者工作特征(ROC)曲线分析血清Myostatin、DLL1水平对HFpEF患者预后不良的评估价值。结果HFpEF组血清Myostatin、DLL1水平及LVEDD、LVPWT、IVST、LVMI均高于对照组(P<0.05)。HFpEF患者血清Myostatin、DLL1与LVEDD、LVPWT、IVST、LVMI均呈正相关(P<0.05)。随访1年后,HFpEF患者预后不良发生率为33.33%(39/117)。多因素Logistic回归分析显示,纽约心脏协会(NYHA)心功能分级≥Ⅲ级、有高血压和LVEDD、N末端B型利钠肽前体(NT-proBNP)、Myostatin、DLL1升高为HFpEF患者预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,血清Myostatin联合DLL1预测HFpEF患者预后不良的曲线下面积高于各指标单独预测。结论HFpEF患者血清Myostatin、DLL1水平升高,且与心室重构加重和预后不良有关。血清Myostatin、DLL1联合检测对HFpEF患者预后不良具有较好的评估价值。
Objective To investigate the relationship between serum Myostatin,delta like canonical Notch ligand 1(DLL1)and ventricular remodeling indexes and prognosis in patients with heart failure and preserved ejection fraction(HFpEF).Methods A total of 117 HFpEF patients who were admitted to Handan First Hospital from January 2021 to January 2022 were selected as HFpEF group.Another 100 healthy individuals who underwent physical examination during the same period were selected as control group.Serum Myostatin,DLL1 levels and ventricular remodeling indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT),end-diastolic interventricular septum thickness(IVST),left ventricular mass index(LVMI)]were compared between HFpEF group and control group.The correlation between serum Myostatin,DLL1 and ventricular remodeling indexes in HFpEF patients were analyzed by Pearson correlation analysis.According to the prognosis of 1-year follow-up,HFpEF patients were divided into poor prognosis group and good prognosis group.The influencing factors of poor prognosis in HFpEF patients were analyzed by multivariate Logistic regression.The evaluation value of serum Myostatin and DLL1 levels for poor prognosis in HFpEF patients was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum Myostatin,DLL1,and LVEDD,LVPWT,IVST,LVMI in HFpEF group were higher than those in control group(P<0.05).Serum Myostatin and DLL1 were positively correlated with LVEDD,LVPWT,IVST and LVMI in HFpEF patients(P<0.05).After 1 year of follow-up,the incidence of poor prognosis in 117 HFpEF patients was 33.33%(39/117).Multivariate Logistic regression analysis showed that NYHA cardiac function grade≥Ⅲ,hypertension and elevated LVEDD,NT-proBNP,Myostatin and DLL1 were independent risk factors for poor prognosis in HFpEF patients(P<0.05).ROC curve analysis showed that the area under the curve of serum Myostatin combined with DLL1 predicted poor prognosis in HFpEF patients was higher than that ind
作者
苗艳丽
李红净
周海静
吴海涛
MIAO Yanli;LI Hongjing;ZHOU Haijing;WU Haitao(Department of Cardiology,Handan First Hospital,Handan,Hebei 056002,China)
出处
《国际检验医学杂志》
CAS
2024年第7期841-846,共6页
International Journal of Laboratory Medicine
基金
河北省2020年度医学科学研究课题计划项目(20202435)。
