| Research backgroundChronic heart failure is a common clinical critical illness in infants and young children,and has high mortality.The diagnosis of CHF in children is based on the clinical features,lacks of sensitivity and specificity of laboratory analysis,and is not conductive to the diagnosis and the degree of the disease. In recent years,heart type fatty acid binding protein,soluble ST2 is discovered as the plasma biochemical markers on the diagnosis of cardiovascular disease, the diagnosis valure in adult acute coronary comprehensive syndrome,myocardial infarction and other diseases has been fully affirmed,the changes in children with acute heart failure have also been reported,but in chronic congestive heart failure in research is not mature. ObjectiveTo study serum levels of heart-type fatty acid-binding protein(H-FABP) and the role of soluble ST2 protein(s ST2) in children with chronic heart failure(CHF), and the correlation with amino-terminal B-type natriuretic peptide precursor(NT-Pro-BNP), NYHA functional class and echocardiographic outcomes, with the aim of studying the significance of H-FABP and s ST2 in CHF. MethodsA total of 39 children with CHF in the first affiliated hospital of Zhengzhou University,including 27 cases of endocardial fibroelastosis(EFE) and 12 cases of dilated cardiomyopathy(DCM) were enrolled in the study.Grouped according to the cardiac functional grading standard(The infant heart failure grouping criteria for modified ROSS scoring method, older children with NYHA classification): in 10 patients with cardiac function of grade 2, 15 cases with cardiac function of grade 3, and 14 cases with cardiac function of grade 4.A total of 30 healthy children severed as the control group.Serum levels of H-FABP and s ST2 were determined using ELISA, and left ventricular ejection fraction(LVEF) and fractional shortening of the left ventricle(FS) were measured by two-dimensional echocardiography in the CHF group.Serum NT-pro-BNP was determined by radioactive immunosorbent assay.Data statistics using SPSS 17 software.Measurement data of normal distribution are to(mean+standard deviation),among the groups are compared using one-way ANOVA analysis of variance.The skewed distribution of measurement data with a median(minimum,maximum),among the groups using the rank sum test,compared using Kruskal-Wallis H test to compare the data of the groups,between the two groups compared using the Mann Whitney U test.The relationship between H-FABP,s ST2 and NT-Pro-BNP and the related indexes is analyzed by Spearman correlation analysis. Results(1)Mean levels of H-FABP and s ST2 in the CHF group were higher than in the control group, and the difference was statistically significant(P<0.05).(2)Serum H-FABP、s ST2 levels were significantly higher in three different heart function, and among the three groups at any of the two groups were statistically significant differences(P<0.05).(3)Mean levels of H-FABP and s ST2 in both the EFE and DCM groups were higher than in the control group, and the difference was statistically significant(P<0.01), but between the EFE and DCM groups, we can’t get the significant result(P>0.05).(4)Serum H-FABP concentrations were positively correlated with s ST2(r=0.621, P<0.01).(5) Serum H-FABP concentrations were positively correlated with NT-Pro-BNP, cardiac function levels(r=0.402, r=0.644, P<0.05), and can’t obtain relevant results with other indicators temporarily. Serum s ST2 concentrations were positively correlated with NT-Pro-BNP, cardiac function levels(r = 0.501, r = 0.678, P<0.05), and were negatively correlated with LVEF, FS(r =-0.340, r =-0.329, P<0.05). Conclusion(1) H-FABP and s ST2 are involved in the development of heart failure.(2) H-FABP and s ST2 can be used as an objective reference index for clinical diagnosis of heart failure, the assessment of the heart function and condition. |
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