Serum β2 Microglobulin Levels And Dilated Cardiomyopathy In Patients With Left Atrial Diameter And Prognosis

Objective:The research aims to study the relationship between the serumβ2 micro-globulin level and the left atrial diameter(LAD)and prognosis of patients with dilated cardiomyopathy respectively.Methods:A retrospective analysis was conducted to consecutively collect 87 cases of inpatients with heart failure due to dilated cardiomyopathy(DCM)between June 2013and January 2017 in the Department of Cardiology,Shengjing Hospital Affiliated to China Medical University.The indicators such as echocardiography and echocar-diography were collected.Through telephone inquiries,outpatient reviews,and case inquiries,a follow-up of the cardiovascular adverse events of all patients within 1 year after discharge including hospitalization for heart failure and cardiac death was carried out.According to the median of serumβ2-microglobulin(β2-MG)levels of hospitalized patients,patients were divided into the highβ2-MG group(β2-MG>3.17mg/L,n=43)and the lowβ2-MG group(β2-MG≤3.17mg/L,n=44).T-test andχ~2test were used to compare the difference between baselines of the two groups.Pearson correlation was used to analyze the correlation between serumβ2-MG levels and left atrial diameter(LAD),and the relationship between serumβ2-MG levels and prognosis of patients with DCM was analyzed through COX regression.Kaplan-Meier method was used to draw the survival function curve for readmission and cardiogenic death of patients with DCM.Results:1.Compared with the lowβ2-MG group,the proportion of patients with severe heart failure in the highβ2-MG group was higher;patients’brain natriuretic peptide,direct bilirubin,urea nitrogen,creatinine,uric acid,cystatin C,hypersensitivity CRP,isotype Cysteine levels were higher,serum sodium and hemoglobin levels were lower,LAD was significantly increased,and LVEF was significantly decreased(P<0.05).2.Correlation analysis showed thatβ2-MG was positively correlated with LAD(r=0.221,P=0.040),negatively correlated with LVEF(r=-0.270,P=0.012),and there is no obvious correlation betweenβ2-MG and LVDD(r=0.108,P=0.321).After correction for gender,age,cardiac function class,arrhythmia,hypertension,BUN,CR,UA,and drug treatment programs,the results of further partial correlation analysis showed that the significant correlation betweenβ2-MG and LAD(r=0.330,P=0.014)still exists.3.Multivariate Cox regression analysis showed that after adjustment for HCY,BUN,and Cr levels at admission,the high serumβ2-MG level(HR=1.148,95%CI:1.010-1.304,P<0.05)was one important independent predictor of the rehospitalization and cardiac death of patients with DCM due to heart failure.4.Kaplan-Meier survival curve analysis showed that in the 12-month follow-up period,the average survival time of patients without adverse events in the highβ2-MG group was 3.9 months(95%CI:3.0-4.8 months);the average survival time of patients without adverse events in the lowβ2-MG group was 5.9 months(95%CI:4.5-7.3 months);and the difference between the two groups was statistically significant(P=0.030).Conclusion:The Serumβ2-MG level in patients with DCM is positively correlated with LAD,and the high serumβ2-MG level is a predictor of the re-hospitalization and cardiac death of patients with DCM due to heart failure.