Comparative Differences In Clinical And Laboratory Related Biomarkers In Patients With Different Ejection Fraction Heart Failure

[objective]By observing the clinical and laboratory related biomarkers such as age, Albumin,low-density lipoprotein cholesterol,Free triiodothyronine levels in Patients with different ejection fraction heart failure And the relationship of BNP in differences pathogenesis of heart failure.Analyze low LDL-C and FT3 levels in predicting the occurrence of heart failure with preserved ejection fraction (HFpEF).[Methods]Select patients who were treated in the Department of Cardiology, the Second Affiliated Hospital of Kunming Medical University from March 2016 to December 2016 (177 cases, including 116 males and 61 females).According to the chronic Heart failure diagnosis and treatment guidelines of Chinese Medical Society in 2014[1],patients were divided into heart failure group(151) and normal group(26).And according to the chronic Heart failure diagnosis and treatment guidelines of ESC in 2016,patients were divided into HFrEF group (57),HFmrEF group(29),and HFpEF group(65).The patients with normal BNP and LVEF were selected as the control group(26). Collecting the data of clinic history and laboratory related biomarkers,including smoking and drinking history,complications,drug therapy,blood pressure,heart rate,thyroid function ,myocardial injury makers and so on.We observed and followed up the difference among the heart failure groups and normal group for 3months. All statistical analysis were performed with Statistical Product and Service Solutions(SPSS) version 22.0,Continuous variables were expressed by mean ±stangard deviation,if P value was lower than 0.05,the result was considered as statistically significant.[Results]1 .The difference in different ejection fraction heart failure and control group:age(Z=13.820,P=0.001),NYHA heart function,pathogenesis of heart failure,Alb?LDL-C?FT3 levels and drug therapy were different in heart failure groups and normal group,there were statistic significantly,and P value was lower than 0.05 .And there has no difference in rehospitalization rate of HFpEF group and HFrEF group(Z=2.221 , P=0.329).The level of BNP were no significant difference in the CHD,DCM,PHD groups(x2?1.951,P=0.583).2.Comparison between different ejection fraction heart failure groups:The patients with HFrEF has younger average age(P< 0.017), poor heart function(P < 0.05) and high incidence of coronary heart disease.Age,NYHA heart function,FT3,Alb,LDL-C levels were no significant difference between HFmrEF group and HFpEF group,HFrEF group.The level of Alb and LDL-C in HFpEF group was lower than that in HFrEF group,and the patients in HFrEF group has younger average age,the P value was larger than 0.05. FT3,Alb, LDL-C was no significant difference in the HFrEF and HFmrEF group with normal group,and the P value was lower than 0.05.The drug therapy such as ACEI,digoxin,spironolactone,furosemide and statin was no significant difference in the heart failure groups and normal group,and the P value was larger than 0.05.3. Analysis of related factors of HFpEF: single factor Logistic regression analysis showed Age (OR=1.041,P=0.021),and low level of FT3 (OR=0.375, P=0.014).Alb(OR=0.886, P=0.029).LDL-C(OR=0.499, P=0.020) were risk factor for HFpEF. And Multivariate factor Logistic regression analysis showed low level of FT3 (OR=0.411,P=0.035),LDL-C(OR=0.387,P=0.027) were independent protective factor for HFpEF.4.The ROC curve analysis of the index HFpEF:the HFpEF was the dependent variable,LDL-C,FT3 as independent variables,and were performed ROC curve analysis.The results show that AUC of LDL-C and FT3 diagnosed with HFpEF were 0.676 and 0.712,and there were statistically significant,the P value was lower than 0.05,and the cutoff values were 2.67mmol/L and 3.65pmol/L.[conclusions]1 .Patients with HFrEF has younger average age, poor heart function and high incidence of coronary heart disease (CHD).And patients with HFpEF has lower level of Alb,LDL-C.HFpEF group and HFrEF group has no difference in therapy and rehospitalization rate of heart failure during three months follow-up.The BNP has no significant difference among differences pathogenesis of heart failure group.2.Comparison between HFpEF group and control group:Age and low level of Alb were risk factor for HFpEF,excluding the influence of age and nutritional condition,low level of LDL-C and FT3 were still independent risk factor for HFpEF.3.When the level of LDL-C cut-off value was 2.67mmol/L,the sensitivity and specificity of predictive the prevalence of HFpEF were 0.770,0.632,And When the level of FT3 cut-off value was 3.65pmol/L,the sensitivity and specificity of predictive the prevalence of HFpEF were 0.621,0.368.