| Objective: To study the changes in the levels of vWF and ET-1 activation,indicators of microvascular inflammation,in patients with heart failure(HF)combined with type 2 diabetes mellitus(T2DM),and to investigate their correlation with indicators of cardiac function and glucose metabolism,as well as their diagnostic value in the cardiac function of patients with HF.Methods: One hundred and twenty-five patients with HF who were hospitalized in the Department of Cardiology of the First Affiliated Hospital of Shihezi University School of Medicine in Xinjiang from April2021 to August 2022 were consecutively included,and were divided into HF-T2 DM group(63 cases)and HF group(62 cases)according to the presence or absence of combined T2 DM,and another 50 patients with cardiovascular disease who were hospitalized at the same time except for HF and T2 DM were selected as the control group,and all study the general clinical data,biochemical indexes,echocardiogram and other data of all the subjects were collected.The levels of vWF and ET-1 were measured by enzyme-linked immunosorbent assay.vWF and ET-1 were analyzed by Pearman and Spearman rank correlation test for correlation with LVEF,NT-pro BNP,FBG and Hb A1 c.The ROC curve was used to calculate the AUC,sensitivity and specificity,and to determine the optimal diagnostic threshold of vWF,ET-1 in patients with HF.Results:1.In the control group,age,HR and the proportion of those with combined coronary heart disease were lower than those in the HF-T2 DM group and HF group,and SBP and DBP were higher than those in the HF-T2 DM group and HF group,with statistically significant differences(P < 0.05);in the HF-T2 DM group,DBP was lower than that in the HF group,and the proportion of those with combined coronary heart disease was higher than that in the HF group,with statistically significant differences(P < 0.05).2.The control group was lower than the HF-T2 DM group and HF group in the proportion of using ACEI/ARB/ARNI,β-blockers,anti-platelet class and statins,and higher than the HF-T2 DM group and HF group in the CCB class,and the difference was statistically significant(P < 0.05);the HF-T2 DM group was higher than the HF group in the proportion of using ACEI/ARB/ARNI,and the difference was statistically significant(P < 0.05).3.In the control group,BUN,Cr,UA,FBG,Hb A1 c,Cysc,and NT-pro BNP were lower than those in the HFT2 DM group and HF group,and Alb,e GFR,TG,TC,and HDL were higher than those in the HF-T2 DM group and HF group,with statistically significant differences(P < 0.05);in the HF-T2 DM group,FMN,FBG,Hb A1 c,and NT pro BNP were higher in the HF group than in the HF group,and the difference was statistically significant(P < 0.05).4.In the control group,RVOTD,LAD,LVEDD,EDV,and ESV were lower than those in the HF-T2 DM group and HF group,and FS and LVEF were higher than those in the HF-T2 DM group and HF group,and the differences were statistically significant(P < 0.05);LVEF in the HF-T2 DM group was lower than that in the HF group,and the differences were statistically significant(P < 0.05).5.Compared with the control group,the serum vWF and ET-1 expression levels of patients in HF-T2 DM and HF groups were significantly higher,and the differences were statistically significant(P < 0.001).Compared with the HF group,the serum vWF and ET-1 expression levels of patients in the HF-T2 DM group were further increased,and the differences were statistically significant(P < 0.001).6.Correlation between serum vWF and ET-1 and cardiac function and glucose metabolism indexes: Serum vWF expression level was positively correlated with NT-pro BNP,FBG and Hb A1c(r = 0.488,r = 0.351,r =0.435,P < 0.001),and negatively correlated with LVEF(r =-0.574,P < 0.001).Serum ET-1 expression level was positively correlated with NT-pro BNP,FBG and Hb A1c(r = 0.241,r = 0.210,r = 0.273,P < 0.01),and negatively correlated with LVEF(r =-0.319,P < 0.001).7.Diagnostic value of serum vWF and ET-1 in patients with HF: ROC curve analysis of all HF patients showed that the AUC of vWF was 0.893,sensitivity was 79 %,specificity was 92 %,and the best cut-off value was 12.680(P < 0.001);the AUC of ET-1 was 0.701,sensitivity was 62 %,specificity was 68 %,and the best cut-off value was 1.417(P < 0.001).Conclusion:1.Compared with HF patients,HF-T2 DM patients had higher expression levels of vWF and ET-1,which were positively correlated with glucose metabolism indexes such as FBG and Hb A1 c,as well as the severity of cardiac function.2.The microvascular inflammatory indexes vWF and ET-1 have an important role in the development of HFT2 DM,and both of them can be used as observational indicators to determine the severity of HF,and vWF has higher sensitivity and specificity. |
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