Clinical Significance Of Serum Lipoprotein-associated Phospholipase A2 And Cystatin C Levels In Patients With Chronic Heart Failure

BackgroundChronic heart failure(CHF)is the terminal stage of various heart diseases.Its clinical manifestations are mainly dyspnea and physical activity limitation,which seriously affect the social function of patients and bring great threat to national health.Frequent attacks of CHF can dramatically deteriorate cardiac function and increase mortality.Lipoprotein-associated phospholipase A2 is an inflammatory factor secreted by macrophages and lymphocytes,which has the effect of promoting atherosclerosis and has been widely used in the field of cardiovascular and cerebrovascular diseases.Cystatin C is a cystine protease inhibitor and its elevated concentration can increase the incidence rate of coronary heart disease.ObjectiveTo explore the diagnostic value of serum lipoprotein associated phospholipase A2 and cystatin C levels in chronic heart failure and the correlation between them.MethodsA total of 110 CHF patients admitted to our hospital from August 2019 to March 2022 were selected as the study subjects and 55 healthy subjects were selected as the control group.The serum Lp-PLA2 and CysC levels of all the selected subjects were measured and the general clinical data of BNP,left ventricular end diastolic diameter,age,sex,cholesterol and triglyceride were improved.Independent sample T test was performed to compare the serum Lp-PLA2,CysC,BNP,LVEDd levels between the two groups.110 patients with chronic heart failure who met the inclusion criteria were divided into class II(n = 41),class III(n = 36)and class IV(n = 33)according to the diagnostic criteria of NYHA classification of heart failure.To compare the difference of serum Lp-PLA2 and CysC levels between control group and patients with non concentric functional grade CHF.Pearson correlation analysis was used to evaluate the correlation between serum Lp-PLA2 and CysC levels and the severity of CHF.ROC curve to evaluate the diagnostic value and efficacy of serum Lp-PLA2 and CysC levels in chronic heart failure.Results1.The levels of serum CysC,Lp-PLA2,BNP,LVEDd and TG in patients with CHF increased,but the levels of LVEF decreased with statistical significance,(both P<0.05).2.Serum CysC,Lp-PLA2,BNP and LVEDd increased with the increase of functional grade,while LVEF decreased with the increase of functional grade.The levels of serum CysC and Lp-PLA2 in patients with CHF were positively correlated with cardiac function grade(both P<0.05).The levels of serum CysC and Lp-PLA2 in patients with CHF were positively correlated with cardiac function grade,(r=0.884 r=0.636,P<0.05).3.The area under the curve of serum CysC in the diagnosis of CHF was 0.694 and the optimal diagnostic threshold was 0.935mg/L,while the sensitivity was 64% and the specificity was 77.27%.The area under the curve of serum Lp-PLA2 for the diagnosis of CHF patients is 0.888 and the optimal diagnostic threshold is 150.5 μg/L,while the sensitivity is 84% and the specificity is 79.09%.ConclusionsThe levels of serum CysC and Lp-PLA2 were increased in patients with CHF.The levels of serum CysC and Lp-PLA2 have certain diagnostic value for chronic heart failure and are related to its severity.