Correlation Between Plasma CTRP3 Levels And Myocardial Fibrosis In Patients With Dilated Cardiomyopathy

Objective:The aim of this study was to investigate the correlation between myocardial fibrosis and plasma CTRP3 levels in patients with dilated cardiomyopathy detected by CMR.Methods:.Sixty patients with dilated cardiomyopathy who were hospitalized in the Department of Cardiology of a Grade A hospital in Xi’an from December 2019 to December 2020 were selected as the observation group.Sixty-four healthy people who came to our hospital for physical examination from December 2019 to December 2020were the control group.In this study,60 patients with dilated heart disease(male,40,female,20)who met the inclusion and exclusion criteria were included,.64 healthy control group(male,37,female,27)were admitted.The patients were divided into LGE positive group and LGE negative group according to whether they were LGE positive or not.Thirty-seven patients(24 males,13 females)were in the LGE positive group,and 23patients(16 males,7 females)were in the LGE negative group.The age,sex,height(cm),and weight(Kg)of all subjects were recorded in the DCM group and the healthy group,and the body mass index(BMI=weight(Kg)/height(cm)~2]was calculated,and the history of hypertension and diabetes mellitus was asked and recorded in both DCM and control groups,5ml venous blood was collected in the morning of fasting,placed in EDTA anticoagulation tubes,centrifuged,and the supernatant was extracted to determine the plasma CTRP3 concentration by ELISA.The plasma CTRP3 concentration was measured by ELISA and recorded separately.All patients in the DCM group underwent cardiac magnetic resonance examination,and parameters such as LVEF,LVEDV and LVESV were obtained,and ECVwas calculated according to the formula.The baseline data and laboratory tests were compared between the dilated heart disease group and the healthy group,and the baseline data and laboratory tests were compared between the LGE-positive group and the LGE-negative group,and the differential indicators were screened for correlation and regression analysis.ROC curve analysis was performed to evaluate the diagnostic efficacy of CTRP3 for myocardial fibrosis.Results:1.the dilated heart disease group and the healthy control group were compared,and the meaningful between the two groups were found to be statistically significant(P<0.05)in terms of albumin,total cholesterol,triglycerides,fasting glucose,blood creatinine,and CTRP3.In addition,we found that CTRP3 were significantly lower in patients with DCM comparison with healthy group;spearman correlation analysis was performed between plasma CTRP3 concentrations and clinical indicators such as albumin,total cholesterol,triglycerides,fasting glucose,and blood creatinine.The results showed that plasma CTRP3 concentration was positively correlated with albumin(r=0.626,P<0.001),negatively correlated with triglycerides(r=-0.195,P=0.030),creatinine(r=-0.379,P<0.001)and fasting glucose(r=-0.314,P<0.001),and negatively correlated with the diagnosis of cardiomegaly as the dependent variable.The dichotomous logistic regression analysis was performed with the diagnosis of dilated heart disease as the dependent variable,CTRP3 and Other indicators as independent variables,and controlling for confounding factors.The results of binary logistic regression analysis showed that CTRP3、ALB were Independent influence for the development of DCM.2.In the LGE-positive and LGE-negative groups,we found statistically significant differences in CTRP3 and LDL.In addition,CTRP3 concentrations were markedly lower in the LGE-positive group(149.56±13.86 vs.168.52±11.85,P<0.001)compared with the LGE-negative group.There were statistically significant differences in LVEDV,LVESV,LVEF(%),and ECV(%)when comparing cardiac MRI indices between the two groups,with LVEF(%)being markdely lower in the LGE-positive group;ECV(%)values were significantly higher in the LGE-positive group(29.48±8.78)than in the LGE-negative group(35.18±5.34)of patients;spearman correlation analysis was performed between plasma CTRP3 concentrations and cardiac nuclear magnetic parameters indexes such as LVEDV,LVESV,LVEF,and ECV.The results showed that plasma CTRP3 concentration with LVEDV(r=-0.317,P=0.014),LVESV(r=-0.415,P=0.001),and ECV(r=-0.539,P<0.001)was negatively correlated;and positively correlated with LVEF(r=0.476,P=0.030).Binary logistic regression analysis with LGE positivity as the dependent variable showed that CTRP3(OR=1.125,95%CI:1.012-1.251,P=0.030)was an independent risk factor for the development of myocardial fibrosis in patients with DCM;the predictive value of plasma CTRP3 for myocardial fibrosis in patients with dilated cardiomyopathy was assessed by ROC curve.The area under the curve(AUC)of CTRP3 for predicting myocardial fibrosis in patients with dilated cardiomyopathy was 0.853[95%confidence interval:0.751-0.956,P<0.001],and when the cut-off value of CTRP3 was taken as 157.435,its diagnostic value was the highest,with a sensitivity of 75.7%and a specificity of 82.6%.Conclusions:CTRP3 levels are associated with myocardial fibrosis in patients with DCM and can be used to predict myocardial fibrosis.In clinical practice,monitoring plasma CTRP3 in DCM patients can provide new ideas for early identification,intervention and treatment of the disease.