| Objective:To analyze the clinical characteristics,Galectin-3 and NT-proBNP levels of patients with heart failure with midrange ejection fraction(HFmrEF),and to evaluate the prognostic value of Galectin-3 and NT-proBNP to HFmrEF.Methods: From December 2018 to June 2019,120 patients with heart failure who were hospitalized in the cardiovascular ward of the Minda Hospital affiliated to Hubei University for Nationalities and met the diagnostic criteria in the 2018 Chinese Heart Failure Diagnosis and Treatment Guidelines were selected as the test group According to different left ventricular ejection fraction(LVEF),it was divided into 59 cases of heart failure with reduced ejection fraction(HFrEF)and 61 cases of HFmrEF,selected at the same time in our hospital health examination center Thirty-six normal people who underwent routine physical examinations served as a control group,collected all the clinical data of the included subjects and detected the level of Galectin-3,summarized and analyzed them,and discussed their laws.According to the occurrence of major adverse cardiovascular events in patients with HFmrEF during discharge follow-up,they were divided into major adverse cardiovascular events group and non-primary adverse cardiovascular event group,and the differences between Galectin-3 and NT-proBNP levels in the two groups were compared;ROC test was used to analyze Galectin-3.The value of NT-proBNP in diagnosing the outcome of major adverse cardiovascular events in HFmrEF.Results:(1)There were no significant differences between the three groups in terms of gender,smoking history,systolic blood pressure,diastolic blood pressure,hemoglobin,triglycerides,low density lipoprotein levels,and cardiac output(P>0.05);compared with the control group,HFmrEF,HFrEF group hypersensitive C-reactive protein,NT-proBNP,Galectin-3,left ventricular end-diastolic volume,left ventricular end-diastolic diameter,and left atrium inner diameter were increased(P <0.05),serum NT-proBNP in HFmrEF group The level of Galectin-3 was lower than that of the HFrEF group(P<0.05).The left ventricular end-diastolic volume,left ventricular end-diastolic diameter,and left atrium inner diameter of the HFmrEF group were smaller than those of the HFrEF group(P<0.05).(2)The proportion of heart function grades ? and ? in the HFmrEF group is small(P<0.05);the proportion of coronary heart disease and hypertensive heart disease in the HFmrEF group is high,and the proportion of ischemic cardiomyopathy in the HFrEF group is high;HFmrEF Compared with HFrEF,the group had fewer lung infections(P<0.05).(3)The left ventricular end-diastolic volume,left ventricular end-diastolic diameter,high-sensitivity C-reactive protein,Galectin-3 levels,NT-proBNP levels in patients with HFmrEF with major adverse cardiovascular events were higher than those without major adverse cardiovascular events Patients(P<0.05);There were no significant differences in age,heart rate,smoking history,systolic blood pressure,diastolic blood pressure,blood glucose,blood lipids and hemoglobin levels between the two groups(P>0.05).(4)Galectin-3 level(OR 1.909,95%CI 1.053~3.46),hs-CRP level(OR 1.151,95%CI 1.017~1.303),left ventricular end-diastolic volume(OR 1.058,95%CI 1.007)~1.113),left ventricular diastolic diameter(OR 1.743,95%CI 1.006~3.019)is a risk factor for cardiovascular events in patients with HFmrEF.(5)The areas under the curve of Galectin-3 and NT-proBNP predicting the occurrence of maca event in HFmrEF were 0.823(95%CI 0.679~0.968)and 0.732(95%CI 0.600~0.864),respectively.Galectin-3 value of 11.497ng/ml is the best threshold for predicting mace events,with sensitivity and specificity of 78.9% and 92.9%,respectively.The NT-proBNP value of 8955ng/L is the best threshold for predicting mace events,with sensitivity and specificity of 84.2% and 59.5%,respectively.Conclusion:(1)HFmrEF may be an intermediate state of heart failure,taking into account the characteristics of systolic dysfunction and diastolic dysfunction.(2)HFmrEF serum heart failure markers Galectin-3 and NT-proBNP were lower than HFrEF.(3)Increased levels of Galectin-3 and NT-proBNP can predict the poor prognosis of HFmrEF. |
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