| Objective:Serum concentrations of N-terminal brain natriuretic peptide precursor(NT-proBNP)and soluble growth stimulation expression gene 2 protein(sST2)in elderly patients with heart failure with mid-range ejection fraction(HFmrEF)were determined,to investigate the clinical diagnostic value of serum NT-proBNP and sST2 levels in elderly patients with HFmrEF.Method:A total of 128 elderly patients(HFmrEF group)diagnosed with heart failure with mid-range ejection fraction in Fenyang Hospital of Shanxi Province from September2019 to January 2021 and 58 elderly patients(control group)hospitalized for hypertension and arrhythmia during the same period were selected as the study subjects.All subjects’ age,gender,body mass index(BMI),smoking history,heart rate,serum creatinine,total cholesterol,triglyceride and other relevant data were collected,and whether they had coronary heart disease,hypertension,diabetes and other diseases were recorded.All subjects underwent routine echocardiography to detect serum NT-proBNP and sST2 levels,and recorded.Cardiac function classification method based on the New York HFmrEF groups of the patients were divided into group A(NYHA class Ⅱ,31 cases)and group B(NYHA class Ⅲ,46 cases),group C(NYHA class Ⅳ,51 cases)and comparison between groups of baseline data,the differences in the levels of serum NT-proBNP and sST2,using the Spearman correlation analysis,the receiver-operating characteristic curve(ROC)assessment NT-proBNP and sST2 HFmrEF diagnostic value.SPSS 22.0 software was used for statistical analysis of the obtained data,and P<0.05 indicated statistically significant difference.Results:(1)The general information of the subjects in each group showed that there were no statistical differences in age,gender,body mass index,serum total cholesterol,triglyceride,history of diabetes and smoking history among all groups(P>0.05).There were statistically significant differences in systolic blood pressure,number of cases of coronary heart disease and hypertension,heart rate,serum creatinine,LVEDD and LVEF between the HFmrEF group and the control group(all P<0.05).Compared with the control group,the LVEDD of the HFmrEF group was significantly increased and LVEF was significantly decreased(P<0.05).With the increase of NYHA cardiac function grade,the level of LVEDD showed an upward trend,while the level of LVEF showed a downward trend(P<0.05).(2)Serological index results showed that the levels of NT-proBNP and sST2 in the HFmrEF group were significantly higher than those in the control group,and the higher the New York heart function grade,the higher the concentrations of NT-proBNP and sST2 were(all P <0.05).(3)Spearman correlation analysis showed that serum sST2 was positively correlated with NT-proBNP and cardiac function(r=0.473,0.777,respectively,P<0.05),and negatively correlated with left ventricular ejection fraction(r=-0.726,P<0.05).(4)Logistic regression model analysis showed that NT-proBNP(OR=1.001,P<0.05)and sST2(OR=1.144,P<0.05)were independent risk factors for HFmrEF.(5)The ROC curve analysis showed that the area under the curve(AUC)of NT-proBNP and sST2 in the diagnosis of HFmrEF were 0.840(95%CI:0.763～0.918)and0.923(95%CI:0.873～0.973),respectively.The sensitivity was 67.2%,89.7%,the specificity was 94.9%,82.1%,and the cut-off values were 1339.50pg/ml and 15.99ng/ml,respectively.The AUC of HFmrEF was 0.970(95%CI:0.943～0.997),and the sensitivity and specificity were 93.1% and 87.2%,respectively.Conclusion:The elevated levels of NT-proBNP and sST2 at admission are significantly correlated with the cardiac function of elderly patients with HFmrEF.NT-proBNP and sST2 have certain clinical value in the diagnosis of HFmrEF,and the combined detection of the two can improve the diagnostic value of HFmrEF. |
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