Study On The Clinical Value Of Urine ?1-acid Glycoprotein In The Diagnosis Of Chronic Heart Failure

Background:Chronic heart failure?CHF?is a group of clinical syndromes which caused by heart organic or functional diseases damage affecting the ability of cardiac ejection and filling.Chronic heart failure is a serious stage of cardiovascular disease caused by various causes.As the population of global aging and the burden of disease increasing,the morbidity and mortality of heart failure increase year by year,causing serious social and economic burden.Contemporary heart failure classification is often based on left ventricular ejection fraction?LVEF?.Patients of heart failure with different LVEF vary in population characteristics,pathophysiology and treatment.Natriuretic peptides are clinically the most widely used and accepted diagnostic markers,but their detection is affected by many factors.As an acute phase reaction protein,alpha 1-acid glycoprotein?ORM1?involve in inflammation and immune suppression process,and pass through interaction with endothelial glycoprotein more complex to change the permeability of endothelial.It can also pass through the cell membrane,regulating cellular immune response,causing the apoptosis of myocardial cells,resulting in destruction contraction protein decomposition.Studies have confirmed that urine ORM1 is of great diagnostic value in the diagnosis and severity of chronic heart failure?New York Heart Association?.However,the diagnostic value of urine ORM1 in patients with heart failure with different LVEF values needs further study.Objective:This study is to determine the urine alpha 1-acid glycoprotein?ORM1?levels in patients with chronic heart failure?CHF?of different LVEF value of the expression.We compare and analyze urine ORM1 levels in different LVEF value expression differences in patients with CHF,to discuss ORM1 Whether it can be used as a urine protein markers,providing the basis for the diagnosis of CHF.Methods:Zhong Da hospital as a platform,this study into the hospital cardiovascular internal medicine between January 2016 and October 2017 hospital diagnosis of 124cases of patients with chronic Heart failure as the experimental group,on the basis of the ESC guidelines 2016 Heart failure diagnosis,including HFpEF group?Heart Failure with preserved Ejection Fraction,LVEF>50%?50 cases,and HFmrEF group?Heart Failure with 40%less than or less than LVEF<50%?38 cases.HFrEF group?Heart Failure with mid-range Ejection Fraction,40%?LVEF<50%?36cases.At the same time,43 cases without heart failure were in the control group.Acquisition in detail the patient's general data,laboratory examination index,cardiac color ultrasound data,urine samples,complications and medications prior to admission,using enzyme-linked immunosorbent Assay?Enzyme Linked Immunoorbent Assay,ELISA?method to detect numerical concentration of urine ORM1.Results:?1?In HFpEF group,HFmrEF group and HFrEF group,urine ORM1concentrations were 82.08�20.56 ug/mL,79.00�11.90 ug/mL,96.86�10.27ug/mL.Urine ORM1 concentration among the three groups was higher than control group?62.77�15.21 ug/mL?,with statistical difference?P<0.05?.Urine ORM1concentration in HFrEF group was higher than the control group,HFpEF group and HFmrEF group,with statistical difference?P<0.05?.?2?The area under the curve(AUC^ROC)of urine ORM1 in the diagnosis of chronic heart failure is 0.838?95%CI0.768⁰.908?.The AUC^ROCOC of urine ORM1 in HFpEF group,HFmrEF group and HFrEF group were 0.778?95%CI 0.684⁰.871?,0.805?95%CI 0.709⁰.901?and0.957?95%CI 0.914⁰.998?.?3?The urine ORM1 concentration in chronic heart failure group associated with coronary heart disease,hypertension was higher than the control group,with statistical difference?P<0.05?.In HFrEF group associated with coronary heart disease,hypertension,the urine ORM1 concentration have the highest diagnostic value?AUC^ROCOC respectively 0.923,0.947?.Conclusions:?1?Urine ORM1 can be used as an important reference indicator for the diagnosis of chronic heart failure,and has better diagnostic value in HFrEF.The differential diagnostic value in HFpEF and HFmrEF is limited.It has the value of high efficiency,economy,simple,noninvasive and preliminary screening diagnosis,especially suitable for out-patients with heart failure.?2?Urine ORM1 level is of great significance for the diagnosis of chronic heart failure associated with coronary heart disease and hypertension.The diagnostic value is better in HFrEF associated with coronary heart disease and hypertension.