| Objective:By measuring the concentration of serum Corin,Atrial natriuretic peptide(ANP),Neprilysin(NEP),Soluble growth stimulating gene 2(sST2),Galectin-3(Galectin-3)in patients with ejection fraction preserved heart failure(HFpEF),to explore the correlation between the levels of serum Corin,ANP,NEP,sST2,Galectin-3 and HFpEF,and to provide a theoretical bases of serum ANP,NEP,sST2,Galectin-3 in the clinical diagnosis of HFpEF.Method:From January 2021 to January 2022,40 patients diagnosed as HFpEF for the first time in the Department of Cardiology of the Affiliated Hospital of Inner Mongolia University for Nationalities were selected as the HFpEF group,According to the New York Heart Association(NYHA)cardiac function classification,HFpEF group was divided into group Ⅱ(11 cases),group Ⅲ(15 cases)and group Ⅳ(14 cases).Forty healthy subjects without diabetes,hypertension and severe hepatic and renal insufficiency were selected as the control group.Collect the clinical basic data and plasma samples of the subjects in the HFpEF group and the control group,complete the laboratory routine,echocardiography and the detection of plasma NT pro BNP,detect the concentration of serum Corin,ANP,NEP,sST2,Galectin-3 by enzyme-linked immunosorbent assay(ELISA).SPSS26.0 statistical software was used to analyze the data.The influencing factors of HFpEF were analyzed by logistic regression,The sensitivity and specificity of HFpEF diagnosis were estimated by ROC curve,P<0.05 indicating that the difference was statistically significant.Results:1.Comparison of basic data between HFpEF group and control group: The prevalence of hypertension,diabetes,coronary heart disease and atrial fibrillation in HFpEF group is higher than that in control group.Age,male female ratio,blood glucose,blood creatinine,urea nitrogen,glutamic oxaloacetic transaminase,glutamic pyruvic transaminase,total cholesterol,triglycerides,low-density lipoprotein,high-density lipoprotein indicators had no significant difference(P>0.05).2.The serum concentration of serum ANP,sST2,Galectin-3 in HFpEF group was higher than those in the control group,while the concentration of serum NEP in HFpEF group was lower than that in the control group,the difference was statistically significant(P<0.05).With the increase of NYHA cardiac function level,the levels of ANP,sST2,Galectin-3 gradually increased,and the level of NEP gradually decreased,and there were intra-group differences among the three groups(P<0.05).3.In HFpEF group,serum ANP,sST2,Galectin-3 and NEP concentrations were positively correlated with left atrial volume index(LAVI),II mean interventricular septum lateral wall E/e ’(AS-L E/e’),and left atrial diameter(LAD)(P<0.05).4.The influencing factors of HFpEF were analyzed by logistic regression: ANP,Galectin-3and NEP were independent influencing factors of HFpEF.The increase of Galectin-3increased the occurrence of HFpEF(OR=1.989,95% CI 1.210-3.268),the increase of ANP increased the occurrence of HFpEF(OR=1.033,95% CI 1.007-1.060),and the increase of NEP decreased the occurrence of HFpEF(OR=0.986,95% CI0.976～0.995).5.The area under the curve(AUC)of receiver operator characteristic curve(ROC)curve was used to evaluate the predictive efficacy of serum ANP,NEP,sST2,Galectin-3,NT pro BNP for HFpEF.The results showed that the AUC of ANP,NEP,sST2,Galectin-3,NT pro BNP from large to small was: sST2: AUC=0.920,cut-off value was 46.255,specificity was 97.5%,sensitivity was 87.5%;Galectin-3:AUC=0.862,cut-off value is 5.855,specificity is 77.5%,sensitivity is 92.5%;NT pro BNP: AUC=0.853,cut-off value is 1169.72,specificity is 87.5%,sensitivity is 80.0%;ANP: AUC=0.835,cut-off value is 73.505,specificity is 55.0%,sensitivity is 100%;NEP: AUC=0.800,cut-off value 236.925,specificity 67.5%,sensitivity is 90.0%.Conclusion:Serum ANP,sST2,Galectin-3 and NEP can reflect the severity of HFpEF,and are the influencing factors of HFpEF,and have certain predictive value for the diagnosis of HFpEF. |
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