Expression And Clinical Significance Of Serum ANP 、 SST2 And Glal-3 In Patients With Chronic Heart Failure Complicated With Atrial Fibrillation

ObjectiveTo investigate the expression of atrial natriuretic peptide（ANP）,soluble human matrix lysin2（s ST2）and galactose lectin 3（Gal-3）in patients with chronic heart failure（CHF）complicated with atrial fibrillation（AF）.To explore the correlation between the expression levels of serum ANP,s ST2,Gal-3 and clinical indexes in this kind of patients.To explore the diagnostic value of serum ANP,s ST2 and Gal-3 in this kind of patients.MethodsA total of 95 patients with chronic heart failure were selected from November 2020 to November 2021 in the Department of Cardiology,the second affiliated Hospital of Shenyang Medical College.There were 56 male patients and 39 female patients,including 48 patients with atrial fibrillation（CHF-AF group）and 47 patients with sinus rhythm（CHF-SR group）.In the same period,30 healthy persons were selected as the control group,including 12 males and 18 females.All selected patients met the inclusion and exclusion criteria.Elbow venous blood was collected from each patient in CHF-AF group,CHF-SR group and control group within 12 hours after admission.The concentrations of serum ANP,s ST2 and Gal-3 were detected by enzyme-linked immunosorbent assay（ELISA）.The clinical data of the three groups,such as clinical biochemical indexes and cardiac ultrasound indexes,were collected.The data were statistically analyzed by SPSS26.0 software.The clinical data and the expression levels of serum ANP,s ST2 and Gal-3 in the three groups were compared,and the correlation between them and clinical indexes was compared.The receiver working characteristic（ROC）curve was drawn,and the area under the curve（AUC）was calculated to explore the diagnostic value of ANP,s ST2 and Gal-3 in CHF-AF and CHF-SR.Results1.Comparison of clinical baseline data: there was no significant difference in sex,age,smoking history,drinking history and so on among the three groups（P > 0.05）.The systolic blood pressure in CHF-AF group was lower than that in CHF-SR group,and the left atrial diameter（LA-D）in CHF-AF group was larger than that in CHF-SR group（P<0.05）.2.Comparison of the expression levels of ANP,s ST2 and Gal-3 between the two groups: the concentrations of ANP,s ST2 and Gal-3 in CHF-AF group and CHF-SR group were higher than those in control group,and those in CHF-AF group were higher than those in CHF-SR group（P<0.05）.3.Correlation analysis: in CHF-AF group and CHF-SR group,ANP,s ST2 and Gal-3 had no significant correlation with sex,body mass index（BMI）and serum creatinine（Scr）,but had significant correlation with NT-pro BNP,cardiac ultrasound index and cardiac function grade.There was significant positive correlation among ANP,s ST2 and Gal-3（P<0.05）.4.The diagnostic value of serum ANP,s ST2 and Gal-3 in CHF-AF and CHF-SR: the AUC of the ROC curve of ANP,s ST2 and Gal-3 in the diagnosis of CHF-AF was 0.885,0.897 and 0.812 respectively,and the best critical values were 691.085pg/ml,990.44pg/ml and 17.025ng/ml,respectively.The sensitivity was 81.3%,81.3% and 79.2%,and the specificity was 93.3%,96.7%and 86.7%,respectively.The AUC of ROC curve of ANP,s ST2 and Gal-3 for diagnosing CHF-SR were 0.764,0.784 and 0.793 respectively,and the best critical values were 693.35pg/ml,990.575pg/ml and 17.025ng/ml,respectively.The sensitivity was 59.6%,61.7% and 72.3%,and the specificity was 93.3%,96.7% and 86.7%,respectively.The AUC for CHF-AF and CHF-SR was 0.833 and 0.872,respectively.The AUC of ANP+s ST2+Gal-3 joint diagnosis of CHF-AF and CHF-SR were 0.933 and 0.811,respectively.The AUC of CHF-AF and CHF-SR were 0.918 and 0.825,respectively.The AUC of CHF-AF and CHF-SR were 0.906 and 0.827,respectively.The AUC of CHF-AF and CHF-SR were 0.851 and 0.823,respectively.ConclusionsANP,s ST2,Gal-3 are closely related to the occurrence of CHF-AF,and the correlation analysis shows that the expression levels of ANP,s ST2 and Gal-3 are positively correlated with LA-D,LVEDV,LVESV and cardiac function grade of CHF-AF,and negatively correlated with LVEF.All of them can reflect myocardial remodeling and the severity of the disease to some extent.At the same time,ANP,s ST2 and Gal-3 all have high diagnostic value for CHF-AF,and the combination of the three can improve the diagnostic value of the disease.