| Objective: The changes of soluble ST2(sST2)in elderly patients with heart failure were analyzed retrospectively,and the correlation between the level of sST2 and cardiac function grade,left ventricular ejection fraction(LVEF)and BNP was further analyzed,and the diagnostic value of sST2 in elderly patients with heart failure was discussed.Methods: A total of 195 patients aged 65 years or older with acute decompensated heart failure treated in the first Hospital of Handan City from 2018 to2019 were selected.According to the cardiac function classification of New York Heart Association(NYHA),the study group was divided into three groups: cardiac function II group,cardiac function III group and cardiac function IV group.75 patients aged 65 years or older with non-heart failure who were hospitalized in the same period were collected as the control group.The general clinical data of the patients were collected,and the levels of sST2 and BNP were measured.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were measured by echocardiography.The changes of sST2 and BNP in heart failure group and control group were analyzed,and the differences of sST2 and BNP in patients with different cardiac function grades were compared.The correlations between sST2,BNP and LVEF,cardiac function classification,and the correlation between sST2 and BNP were analyzed.ROC curve was used to analyze the diagnostic value of sST2,BNP and their combination in elderly patients with heart failure.Results:1.Compared with the control group,the levels of sST2 and BNP in the heart failure group were significantly higher(P < 0.01).The LVEF level in the heart failure group was significantly lower than that in the control group(P < 0.01).The history rate of diabetes in the heart failure group was higher than that in the control group(P< 0.05),and the levels of serum creatinine(Cr)and LVEDD in the heart failure group were higher than those in the control group(P < 0.01).2.The comparison of cardiac function among II,III and IV groups showed that the level of sST2 in III group was not significantly higher than that in II group(P >0.05),but the level of sST2 in IV group was significantly higher than that in II group(P < 0.01),and the level of sST2 in IV group was higher than that in III group(P <0.05).3.There was a positive correlation between sST2 and NYHA cardiac function grade(r = 0.423,P < 0.01),a negative correlation between sST2 and LVEF(r =-0.056,P < 0.01),and a positive correlation between sST2 and BNP(r = 0.410,P < 0.01).4.The area under the ROC curve of serum sST2 in the diagnosis of senile heart failure was 0.811.When the optimal threshold of sST2 was set to 23.06ng/ml,the sensitivity was 74.2% and the specificity was 75.9%.The area under the ROC curve of BNP in the diagnosis of senile heart failure was 0.951.When the optimal threshold of BNP was set to 144.15pg/ml,the sensitivity was 91.2%,and the specificity was81%.The value of the combination of sST2 and BNP in the diagnosis of senile heart failure was 0.973,the sensitivity was 95%,and the specificity was 86.2%.Conclusions:1.The level of serum sST2 in heart failure group was significantly higher than that in non-heart failure group,and the degree of increase was significantly correlated with the degree of heart failure.2.SST2 level was positively correlated with NYHA cardiac function grade,negatively correlated with left ventricular ejection fraction(LVEF),and positively correlated with BNP level.3.SST2 has obvious diagnostic value for heart failure.BNP combined with sST2 can improve the sensitivity and specificity of heart failure in the elderly,and further improve the diagnostic value.SST2 may become a new biochemical index for the diagnosis of heart failure in the elderly. |
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