| Background Acute Myocardial Infarction(AMI)is the world’s highest incidence and mortality of cardiovascular emergencies.Ventricular remodeling is a follow-up to myocardial infarction,which can lead to heart failure and even death.The rate of progression to chronic heart failure(CHF)every year is 2%.Once the symptoms and signs of heart failure appear,the mortality rate is still high,and the 5-year survival rate is similar to cancer.Early diagnosis and understanding of candidate gene regulatory targets are essential to improve prognosis in patients.Recent studies have shown that long non-coding RNA(lnc RNA)play an important role in the physiological and pathological state of the cardiovascular system.It is expected to be a new class of biomarkers for human disease.Studies have shown that lnc RNA-LIPCAR,which is elevated in circulation in patients with advanced myocardial infarction,is positively associated with prognosis.It can be used as a new biomarker to evaluate the survival rate of patients with heart failure.However,the expression of LIPCAR in the early stage of acute heart failure and acute exacerbation of chronic heart failure is unknown.Recently,it has been found that there is a lnc RNA-Chast in mice,which can be overexpressed in hypertrophic cardiomyocytes.Over expression and silencing may lead to the occurrence and termination of hypertrophy,which may become a potential therapeutic target for myocardial hypertrophy.CHAST has been found in hypertrophic heart tissue and hypertrophic cardiomyocytes in patients with aortic stenosis.But whether CHAST can be measured in blood for clinical diagnosis has not been studied.The trend and mechanism of myocardial hypertrophy as an important molecular biological change after myocardial infarction are unknown.Objective To explore the circulating levels of LIPCAR and CHAST in control group、acute myocardial infarction(AMI)group different in time points and chronic heart failure(CHF)group,to evaluate the change trend,clinical significance and the diagnostic value,provides more theoretical basis for further study of mechanism.Methods According to the selection criteria,321 patients were selected from February 2016 to October 2017 in department of cardiology,the first affiliated hospital of Xinxiang Medical University.The control group consisted of 80 cases,the acute myocardial infarction group consisted of 53 cases,the chronic heart failure group consisted of 188 cases.All patients were informed and signed consent letter.Accurate records of clinical data: sex,age,past medical history,and clinical indicators: blood lipids,NT-pro BNP,CK-MB,echocardiography and so on.Real-time PCR was used to detect LIPCAR and CHAST in the circulation of patients.Results 1.The expression of LIPCAR in AMI group and chronic heart failure group was significantly lower than control group(P < 0.01).The expression of CHAST was significantly increased within 24 hours after acute myocardial infarction(P < 0.01),3~5 days later decreased and there was no difference between CHD group.Compared with the control group,the difference was not statistically significant,but with the trend of increase.2.LIPCAR was negatively correlated with NT-pro BNP、CK-MB、Scr、Cys C、LVDd,whereas positively correlated with e GRFR and EF(P<0.01).CHAST was positively correlated with CK-MB and c Tn I(P<0.01).In addition,the subgroup analysis of CHF showed that the patients complicated with renal insufficiency exhibited a tendency of lower levels of LIPCAR(0.83±0.25 vs.0.74±0.37,P =0.06).There is no difference between LIPCAR and CHAST in CHF after myocardial infarction and other causes.3.AUC was 0.785(95% CI = 0.732~0.838)for LIPCAR to judge CHF,CHAST was 0.622 to judge AMI(95% CI = 0.551~0.692).Conclusion 1.The expression of lnc RNA LIPCAR in patients with acute myocardial infarction and chronic heart failure was significantly correlated with the indexes of heart failure and heart function,and could be used as a biomarker for the diagnosis of heart failure.2.Lnc RNA CHAST can be detected in circulation and increased significantly within 24 hours of acute myocardial infarction,and can be used as a potential biomarker for disease diagnosis.3.The expression level of LIPCAR in patients with chronic heart failure complicated with renal dysfunction decreased further.And there is no difference between LIPCAR and CHAST in CHF after myocardial infarction and other causes. |
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