Application Value Of Midregional Pro-atrial Natriuretic Peptide In Heart Failure Patients With Different Ejection Fractions

Objective:The aim of this study was to explore the changes of midregional sequence of pro-A-type natriuretic peptide(MR-proANP)levels in heart failure(HF)patients with different ejection fractions,providing new ideas for the diagnosis of heart failure with different left ventricular ejection fractions.Methods:Participants with cardiovascular disease who were enrolled in this study were divided into the HFr EF group(n=41),HFmr EF group(n=27),HFp EF group(n=31)and control group(n=28).The MR-proANP and NT-pro BNP levels in plasma from all patients were measured by enzyme-l inked immunosorbent assay.The concentration levels of MR-proANP in heart failure patients with different NYHA(New York Heart Association)grade and ejection fraction levels were observed.The diagnostic values of MR-proANP,with or without NT-pro BNP combined detection for heart failure with different ejection fraction was analyzed.Results:1.The plasma levels of MR-proANP in the HF and control groups were significantly different(P<0.05).The levels of MR-proANP in HFp EF,HFmr EF and HFr EF groups increased successively,but differences among HFp EF,HFmr EF and HFr EF groups had no difference(P>0.05).2.MR-proANP showed a positive correlation with NT-pro BNP and NYHA class(r_s=0.608,P=0.000;r_s=0.208,P=0.038,respectively),but MR-proANP levels were no significant different in different New York Heart Association class patients(P>0.05).3.Diagnostic value of MR-proANP and NT-pro BNP levels in HF patientsThe area under the curve(AUC)of MR-proANP in the diagnosis of heart failure and HFr EF patients was 0.771 and 0.668,respectively,and that of NT-pro BNP in the diagnosis of heart failure and HFr EF patients was 0.887and 0.736.The AUC of combined plasma MR-proANP and NT-pro BNP in the diagnosis of heart failure and HFr EF patients was 0.888 and 0.726,respectively.The AUC of MR-proANP and NT-pro BNP in the diagnosis of HFp EF and HFmr EF patients were not significantly different(P>0.05).Conclusions:1.Plasma level of MR-proANP was significantly increased in patients with heart failure,and was positively correlated with NYHA class.2.Plasma MR-proANP and NT-pro BNP levels have better diagnostic value for patients with heart failure.The sensitivity of MR-proANP in the diagnosis of heart failure is higher than that of NT-pro BNP,and combined detection is better than that of MR-proANP alone.3.Plasma MR-proANP has certain reference value in the diagnosis of reduced ejection fraction heart failure patients.