Study On The Relationship Between Ischemic Cardiomyopathy's TCM Syndrome And SST2

Objective: To investigate the relationship between Ischemic Cardiomyopathy's(ICM)TCM syndrome and human soluble growth STimulation expressed gene 2(sST2),and to provide new objective indicators and theoretical basis for ICM's TCM syndrome differentiation.Methods: 116 ICM patients(ICM group)and 26 healthy persons(healthy control group)were selected.The ICM group was divided into TCM syndrome and NYHA classification.Basic clinical data of all enrolled persons were recorded,and serum sST2,N-terminal pro-B-type natriuretic peptide(NT-pro BNP),routine blood test,echocardiography and other related indicators were examined.All the data were analyzed by SPSS20.0 statistical software.Results:(1)The serum sST2 level in ICM group was 1790.25 pg/ml(1238.27 pg/ml-2168.96 pg/ml),which was significantly higher than that in healthy control group(733.32 pg/ml,592.23 pg/ml-854.6 pg/ml)(P<0.01).(2)The levels of serum sST2 in all TCM syndromes were significantly abnormal,and increased with the evolution of Qi Deficiency complicated with Blood Stasis(QDBS),Qi Yin Deficiency complicated with Blood Stasis(QYDBS),Yang Deficiency complicated with Water Flood complicated with Blood Stasis(YDWFBS)(P<0.05).The level of serum sST2 in Phlegm-Blood Stasis(PBS)was lower than that in YDWFBS(P<0.05).There was no significant difference between PBS and QYDBS,and between PBS and QDBS(P>0.05).The levels of NT-pro BNP in all TCM syndromes were significantly abnormal,and increased with the evolution of QDBS,PBS/ QYDBS,YDWFBS(P<0.05).There was no significant difference between the PBS and QYDBS(P>0.05).(3)According to NYHA classification,with the evolution of QDBS,PBS/QYDBS,YDWFBS,the class of heart failure is gradually aggravated: QDBS mainly distributes in NYHA class II to III,YDWFBS mainly distributes in NYHA class III to IV,which has statistical significance compared with other TCM syndromes(P<0.05);PBS and QYDBS were both distributed in NYHA class II to IV,and there was no significant difference between them,but there was significant difference between them and other TCM syndromes(P<0.05).(4)According to NYHA classification,the serum levels of sST2 and NT-pro BNP increased with the severity of heart failure,the difference was statistically significant(P<0.05).(5)Spearman correlation analysis showed that serum sST2 was negatively correlated with left ventricular ejection fraction(LVEF)in ICM patients(r=-0.309,P<0.01).Kruskal-Wallis H rank sum test showed that the serum sST2 level in the severely reduced group of LVEF was higher than that in the mildly and moderately reduced groups(P<0.05),there was no significant difference in the serum sST2 level between the mildly and moderately reduced groups(P>0.05).Serum sST2 level in mild abnormal group of LVEDd was lower than that in moderate abnormal group and severe abnormal group(P<0.05),there was no significant difference in serum sST2 level between moderate abnormal group and severe abnormal group(P>0.05).(6)Spearman correlation analysis showed that serum sST2 was positively correlated with NT-pro BNP(r = 0.504,P<0.01)and hypersensitive C-reactive protein(hs-CRP)in ICM patients(r = 0.271,P<0.01).Conclusion:(1)The level of serum sST2 in ICM was significantly higher than that in normal people,and the levels of serum sST2 in all TCM syndromes were significantly abnormal,which gradually increased with the evolution of QDBS,PBS,QYDBS,YDWFBS.(2)Serum sST2 level in ICM was negatively correlated with LVEF,and correlated with the degree of reduction of LVEF.There is no direct correlation with LVEDd,but it may be related to the abnormal degree of LVEDd.According to NYHA classification,the serum levels of sST2 and NT-pro BNP increased with the severity of heart failure.(3)Serum sST2 level was positively correlated with NT-pro BNP and hs-CRP in ICM patients.