Study Of Relationship Between CTRP3 And Ventricular Remodeling After Acute Myocardial Infarction

Objective:1.Clarify the level of peripheral blood expression in patients with acute myocardial infarction(AMI)of C1 q tumor necrosis group 3(CTRP3).2.Explore the correlation between plasma CTRP3 and post-AMI patients’ ventricular remodeling.Method:Taking "Acute ST-stage elevated myocardial infarction and treatment guidelines2019" as the diagnostic criteria for acute myocardial infarction reported by the 2019 Chinese Medical Association Cardiovascular Credit Association,120 patients with acute ST-elevated myocardial infarction were selected for appointment in the department of cardiovascular medicine at Dongguan Branch of Yan’an University Hospital from April2019 to June 2020,and 120 patients with acute ST-stage elevated myocardial infarction were selected as AMI groups.The 90 cases of outpatient health check-ups in the same period were selected as the control group.1.Using ELISA method to determine the level of plasma CTRP3 in AMI group and control group,using ultrasound cardiac chart examination,record the relevant indicators of ventricular remodeling(LVEF、LAD、LVEDD、IVST、LVPWT、LVEDV)of the patients in the control group on the day of physical examination and 1 week and 6 months in the AMI group,and the LVMI is calculated using the Devereux formula.2.The AMI group is divided into ventricular remodeling group(ΔLVEDV% ≥20%)and non-ventricular remodeling group(ΔLVEDV%<20%)according to the ΔLVEDV%.Comparing the differences between the general clinical data of AMI group and control group,the ventricular remodeling group and nonventricular remodeling group,the level of plasma CTRP3 and the ventricular remodeling index,the correlation between plasma CTRP3 and ventricular remodeling index was analyzed by Pearson method,and the statistical analysis of Logistic regression analysis,ROC curve and other factors affecting AMI post-arranthmic reconstruction.Result:1.The AMI group was compared with the control group.1.1 Comparing the general baseline data of the AMI group with that of the control groupDifferences in age,sex,diabetes,LDL-C,HDL-C,serum creatinine(Scr)were not statistically significant between the control group and the AMI group(P>0.05);Hypertension,body mass index(BMI),amino terminal brain natriuretic peptide(NT-Pro BNP),triglycerides(TG),total cholesterol(TC)in the control group were significantly lower than in the AMI group,with statistically significant differences(P<0.05).1.2 The comparison between the AMI group and the control group plasma CTRP3Plasma CTRP3 was 31.94±8.54 ng/m L in the control group,plasma CTRP3 was17.88±9.55 ng/m L in patients in the AMI group,and plasma CTRP3 in the control group was significantly higher than in the AMI group,with a statistically significant difference(P<0.05).1.3 The comparison of the AMI group with the control group’s indicators of ventricular remodelingThe control group LVEF was significantly higher than the AMI group,and the difference was statistically significant(P<0.05).The control group LAD,LVEDD,IVST,LVPWT,LVEDV,LVMI were significantly lower than the AMI group,the difference is statistically significant(P<0.05).2.The ventricular remodeling group was compared with the non-ventricular remodeling group.AMI patients followed for 6 months,recorded the relevant indicators of ventricular remodeling of follow-up(6 months),to whether the ΔLVEDV% exceeded 20% as the standard: ΔLVEDV% ≥ 20% for ventricular remodeling group,ΔLVEDV% < 20% for non-ventricular remodeling group.Including ventricular remodeling groups: 32 cases,nonventricular remodeling groups: 88 cases.2.1 Comparing the general baseline data of the ventricular remodeling group and nonventricular remodeling groupDifferences in age,sex,diabetes,hypertension,smoking history,BMI,NT-Pro BNP,TG,TC,HDL-C,LDL-C,Scr,infarction site,and post-hospital treatment were not statistically significant between the ventricular remodeling group and non-ventricular remodeling group(P>0.05).2.2 The comparison between the ventricular remodeling group and non-ventricular remodeling group plasma CTRP3.Plasma CTRP3 was 12.68±7.28 ng/m L in the ventricular remodeling group,plasma CTRP3 was 19.78±9.60 ng/m L in patients in the non-ventricular remodeling group,and plasma CTRP3 in the non-ventricular remodeling group was significantly lower than in the ventricular remodeling group,with a statistically significant difference(P<0.05).2.3 The comparison of the ventricular remodeling group with the non-ventricular remodeling group’s indicators of ventricular remodeling.The non-ventricular remodeling group LVEF was significantly higher than the ventricular remodeling group,and the difference was statistically significant(P<0.05).The ventricular remodeling group LAD,LVEDD,IVST,LVPWT,LVMI are significantly higher than the non-ventricular remodeling group,the difference was statistically significant(P<0.05).3.The correlation analysis between CTRP3 and the ventricular remodeling index3.1 With CTRP3 as the argument and LVEF,LAD,LVEDD,IVST,LVPWT,LVEDV,LVMI,LVEDV as the cause variable,the results show that CTRP3 is positively related to LVEF(r=0.76)1,p<0.001),while LAD、LVEDD、IVST、LVPWT、LVEDV、LVMI and LVEDV were all negatively related(r-0.670,r-0.550,r=-0.796,r=0.744,r=0.756,r=0.734,r=0.610,p<0.001).3.2 Logistic regression analysis of smoking history,hypertension,BMI,NT-Pro BNP,TG,TC,CTRP3 and other indicators and ventricular remodeling showed that CTRP3,BMI entered the regression equation,CTRP3 OR value was 0.932,95% CI(0.887,0.980),BMI OR value was 1.422,95% CI(1.084,1.866),indicating that BMI is an independent risk factor for assessing ventricular remodeling,while CTRP3 is a protective factor for a postAMI ventricular remodeling.3.3 CTRP3 on the ROC curve of ventricular remodeling after AMIThe best truncation value for ventricular remodeling after CTRP3 diagnosis of AMI is: 14.703,sensitivity: 68.2%,specificity: 62.5%,and the area diaspored under the curve is 0.711,95% CI(0.611,0.810).Conclusion:1.The concentration of CTRP3 decreased significantly in the plasma of patients with acute myocardial infarction.2.In patients with acute myocardial infarction,plasma CTRP3 is associated with ventricular remodeling,and with the decrease of CTRP3 and the increase of ventricular remodeling,CTRP3 is the protective factor of ventricular remodeling after AMI,which can be used to predict ventricular remodeling.