| Objectives:We observated the changes of stromal cell-derived factor 1(SDF-1),chemokine ligand 16(CXCL16),N-terminal probrain natriuretic peptide(NT-proBNP)and high sensitive C-reactive protein(Hs-CRP)levels in including HF with mid-range ejection fraction(HFmrEF)group of chronic heart failure(CHF),and assessing its for the diagnostic value in patients CHF.Methods:A total of 127 consecutive patients admitted to our hospital for CHF were divided into three groups of HFpEF(n=68),HFmrEF(n=30)and HFrEF(n=29).And we chose cardiovascular disease in patients with normal cardiac function that in the same period hospitalization as control group(n=33).NT-proBNP was analyzed with Bi-directional Lateral Flow Immunoassay.Hs-CRP was analyzed with latex-enhanced immunonephelometry on an automatic biochemical analyze.SDF-1 and CXCL16 were analyzed with an enzyme linked immunosorbent assay kit(ELISA).Results:1.The levels of SDF-1,CXCL16,hs-CRP and NT-proBNP in patients with CHF were significantly higher than those in control group(all P < 0.01).NT-proBNP and hs-CRP levels in the HFpEF group,HFmrEF group and HFrEF groups gradually increased,and the difference was obvious(all P < 0.05).Compared with the control group,SDF-1 and CXCL16 levels were significantly increased in HFmrEF group(all P < 0.05).Compared with HFmrEF group and HFpEF group,the serum of SDF-1 and CXCL16 levels were significantly increased in HFrEF group(all P < 0.05).The level of SDF-1 between HFpEF and HFmrEF was not statistically significant(P > 0.05),The level of CXCL16 had no statistical significance between HFpEF and control group(P > 0.05).2.Compared with the control group,the values of troponin,left ventricular end-diastolic diameter(LVEDD),left atrial anterior and posterior diameter(LAD)and early diastolic mitral flow velocity to early diastolic mitral annular motion velocity(E/e?)in patients with HFmrEF were significantly higher(both P < 0.01);Compared with the HFpEF group,the values of LVEDD and E/e? were significantly elevated in patients with HFmrEF;compared the patients with HFrEF,the values of troponin,LVEDD,LAD and E/e?in patients with HFmrEF had no statistical significance(both P > 0.05).3.The Correlation analysis showed that the lg(SDF-1)and CXCL16 were positively correlated with lg(NT-proBNP)(r = 0.366,0.345 respectively,all P < 0.01);and negatively related to LVEF(r =-0.354,-0.452 respectively,all P < 0.01).lg(SDF-1)and CXCL16 were positively correlated with hs-CRP(r = 0.300,0.333 respectively,all P < 0.01).lg(SDF-1)and CXCL16 were positively correlated with LVEDD(r = 0.293,0.245 respectively,all P < 0.05).hs-CRP were positively correlated with lg(NT-proBNP)and LVEDD(r = 0.500,0.418 respectively,all P < 0.01);and negatively related to LVEF(r =-0.711,P < 0.01).lg(NT-proBNP)was positively correlated with LVEDD(r = 0.472,P < 0.01);negatively related to LVEF(r =-0.56,P < 0.01).4.To distinguish CHF from controls,the area under of Receiver Operating Characteristic curve(AUC)of NT-proBNP,SDF-1,CXCL16,hs-CRP was 0.910,0.803,0.762,0.811 respectively.The cut-off of these 4 biomarkers was 1319.89pg/ml,2818.9pg/ml,2.85ng/ml,4.75mg/L respectively.The sensibility was 0.91,0.86,0.78,0.73 respectively;the specificity was 0.87,0.69,0.67,0.66 respectively.The specificity of combined detection 4 biomakers was highest(AUC = 0.962,sensibility = 0.83,specificity = 0.97).Conclusions:1.CXCL16 can be used as a biomarker to identify HFmrEF.CXCL16 and SDF-1 are closely related with cardiac function status in patients with CHF,which can reflect the severity of the patients condition,and could be used as biomarkers for the diagnosis of CHF,but its sensitivity and specificity are not superior to NT-proBNP.2.Patients of HFmrEF have a worse systolic and diastolic dysfunction than patients of HFpEF;although the patients of HFmrEF and HFrEF have similar diastolic dysfunction,there are different LVEF.3.Novel biomarkers(CXCL16 and SDF-1)combined with traditional biomarkers(NT-proBNP and hs-CRP)can improve the diagnostic value of CHF. |
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