| Background and ObjectiveHeart failure(HF)is a group of clinical syndromes characterized by cardiac congestion and/or dysfunctional blood displacement caused by multiple etiologies.At present,the diagnosis of heart failure mainly relies on symptoms and signs,and traditional diagnostic aids including echocardiography,electrocardiogram exercise stress test and radionuclide imaging have their shortcomings.In recent years,the emergence of biological markers based on blood tests has provided more information for the diagnosis treatment and prognosis assessment of heart failure patients.Among them serum soluble ST2(sST2)has emerged as a marker of cardiac remodeling and myocardial fibrosis,which are the enabling factors for the progression of heart failure and deterioration of cardiac function.Recent studies have found that the level of sST2 is closely related to cardiac function classification and severity of heart failure,and has some clinical value in heart failure condition assessment and risk stratification.However,no studies related to the decrease of sST2 in the prognosis of patients with chronic heart failure have been seen.In this study,we evaluated the reliability of sST2 in the early identification,diagnosis and treatment risk stratification and prognosis assessment of chronic heart failure patients by observing the correlation between sST2 levels and its post-treatment decline and prognosis of heart failure,and explored the clinical application value of sST2 testing in heart failure patients.Methods120 patients with chronic heart failure treated in our hospital from September 2018 to September 2020 were selected as the heart failure group and 30 patients with normal heart function as the control group.Compare the difference of sST2 level between heart failure group and control group;and compare the difference of sST2 level in heart failure patients with different heart function grades;observe the changes of sST2 and NT-proBNP levels in heart failure-group before and after treatment;according to the decrease of sST2 before and after treatment,the heart failure group was divided into high decrease group(decrease≥ 50%)and low decrease group(decrease<50%).The differences in the incidence of cardiovascular adverse events in hospital and after discharge were compared between the two groups.The patients in the heart failure group were followed up for 6 months,and the occurrence of cardiovascular events was recorded.According to the occurrence of events,the heart failure group was divided into the event group and the non-event group,and the differences of general data and biological markers between the two.groups were compared to explore the diagnostic value of sST2 in the prognosis of heart failure.Through the above comparison,the clinical value of sST2 in the diagnosis,treatment and prognosis of heart failure was analyzed.SPSS26.0 statistical software was used to analyze the data,and P<0.05 was considered to be statistically significant.Results1.The level of sST2 in the heart failure group was significantly higher than that in the control group,and the level of sST2 increased with the increase of New York Heart Association,from(37.27±9.96)ng/ml to(118.15±46.05)ng/ml,the differences were statistically significant(P<0.05).2.Compared with the level of sST2 on admission,the levels of sST2 and NTproBNP in heart failure group after treatment were significantly different(P<0.05).3.There was no significant difference in age,sex composition,smoking history,diabetes history and hemoglobin concentration between the event group and the nonevent group,but there were significant differences in admission sST2,admission NTproBNP level,systolic blood pressure,diastolic blood pressure,Cr,LVEF and LAD(P<0.05).Compared with the high decrease group,the low decrease group had a higher incidence of cardiovascular events during hospitalization and after discharge,and the differences were statistically significant(P<0.05).4.sST2 on admission,sST2 after treatment,decrease of sST2,NT-proBNP on admission and NT-proBNP after treatment were positively correlated with the prognosis of patients with heart failure,the correlation coefficient r was 0.399,0.631,0.383,0.523,respectively,and the decrease of sST2 was negatively correlated with the prognosis,and the correlation coefficient r was-0.414(P<0.05).5.Binary Logistic regression analysis showed that the level of sST2 after treatment was an risk factor for the prognosis of heart failure,and the risk was[OR=1.041(1.015-1.068)P=0.002].The decrease of sST2 was the protective factor for the prognosis of heart failure[OR=0.039(0.004-0.408)P=0.007](P<0.05).6.The diagnostic accuracy of admission sST2,sST2 after treatment,decrease of sST2,admission NT-proBNP and NT-ProBNP after treatment for the prognosis of heart failure were 73.3%,86.8%,74.2%,72.4%and 80.5%,respectively.The diagnostic accuracy of combined sST2 after treatment and NT-proBNP after treatment for the prognosis of heart failure was as high as 89.5%,which was higher than that of any other index alone(all P<0.05).Conclusions1.The level of sST2 in patients with heart failure is significantly higher than that with normal heart function,and its level increases with the increase of NYHA grade,which is related to the severity of heart failure.2.The level of sST2 is positively correlated with the prognosis,and the high concentration of sST2 indicates a poor prognosis.3.The decrease of sST2 is negatively correlated with the prognosis,and high sST2 decrease indicates a better prognosis.4.Combining sST2 after treatment with NT-proBNP after treatment can accurately predict the prognosis of patients with heart failure,and has a strong reference value in evaluating the prognosis of patients with heart failure. |
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