Research On The Correlation Between TCM Syndrome Types Of Chronic Heart Failure And Peptide Hormones Elabela And Apelin

Objective: To explore the relationship between the detection indexes and TCM syndrome differentiation and New York Heart Association(NYHA)cardiac Function classification in order to provide a more objective basis for TCM syndrome differentiation and clinical diagnosis and treatment of CHF,the study examined the plasma levels of Elabela,Apelin,amino-terminal pro-B-type natriuretic peptide(NT-pro BNP)and left ventricular ejection fraction(LVEF)in patients with chronic heart failure(CHF).Methods: 96 CHF patients(NYHA class II-IV)and 32 healthy subjects who met the diagnostic criteria and inclusion criteria were selected.According to NYHA functional criteria for assessment and classification,according to symptoms,signs,tongue,pulse for TCM syndrome differentiation.Plasma Elabela,Apelin,and NT-pro BNP expression levels were measured,and laboratory tests and echocardiography results were collected.Data analysis was completed using SPSS 26.0.Results:(1)There was no statistical difference in age distribution and sex composition between CHF group and control group(P>0.05).The composition ratio of TCM syndrome differentiation and NYHA functional classification in CHF group was similar.(2)High-density lipoprotein cholesterol(HDL-C)was significantly lower in the CHF group compared to the healthy control group(P<0.05).There were significant differences in serum creatinine(Scr)and blood urea nitrogen(BUN)levels among NYHA functional classification groups(P<0.05).(3)Compared with the control group,plasma levels of Elabela,Apelin,NT-Pro BNP and LVEF in CHF group were significantly different(P<0.05).The expression levels of Elabela and Apelin in plasma and NT-Pro BNP of CHF patients in NYHA functional classification groups were statistically different(P<0.05).With the deterioration of cardiac function(NYHA class II-IV),the expression levels of Elabela and Apelin in plasma decreased,while the NT-Pro BNP levels increased.(4)There were significant differences in the levels of low density lipoprotein cholesterol(LDL-C),plasma levels of Elabela,Apelin,and NT-Pro BNP between different TCM syndrome groups in CHF patients(P<0.05).(5)There were significant differences in NYHA classification of different TCM syndromes of chronic heart failure(P<0.05).With the change of syndromes of qi deficiency and blood stasis→qi-yin deficiency and blood stasis→yang deficiency and blood-stasis,the cardiac function gradually deteriorated and the degree of heart failure worsened.(6)Plasma Elabela and Apelin were negatively correlated with NT-Pro BNP,and positively correlated with LVEF.Plasma levels of Elabela and Apelin were negatively correlated with NYHA cardiac function classification and different TCM syndromes,while NT-Pro BNP were positively correlated with NYHA functional classification and different TCM syndromes.Conclusion:(1)The expression levels of plasma Elabela and Apelin decreased with the increase of NT-pro BNP.(2)Compared with non-CHF patients,the expression levels of Elabela and Apelin in CHF patients were significantly lower.Plasma levels of Elabela and Apelin were negatively correlated with the cardiac function grade of CHF patients.With the deterioration of cardiac function(NYHA class II-IV),the expression levels of Elabela and Apelin decreased significantly;NT-pro BNP increased with the deterioration of cardiac function.(3)The levels of plasma Elabela and Apelin were negatively correlated with different TCM syndrome differentiation types of CHF patients.With the change of syndrome types from qi deficiency and blood stasis syndrome to qi-yin deficiency and blood stasis syndrome to yang deficiency and blood stasis syndrome,the expression levels of Elabela and Apelin decreased,and the NT-Pro BNP increase accordingly.(4)The TCM syndrome differentiation of CHF is related to NYHA functional classification.With the change of syndrome types of qi deficiency and blood stasis syndrome→qi-yin deficiency and blood stasis syndrome→yang deficiency and blood stasis syndrome,the cardiac function deteriorates gradually and the degree of heart failure increases gradually.(5)Plasma Elabela and Apelin can be used as biomarkers for chronic heart failure.