| Objective:1.Secreted protein acidic and rich in cysteine(SPARC)and transforming growth factor-β1(transforming growth factor-β1)in plasma were analyzed The expression of factor-β1(TGF-β1)in patients with Chronic heart failure(CHF)and its correlation with cardiac function and the severity of ventricular remodeling.2.To investigate the diagnostic and prognostic value of plasma SPARC and TGF-β1levels in CHF.Methods:1.Patients hospitalized for CHF in the Second Hospital of Shanxi Medical University from April 2021 to June 2022 were selected as the CHF group(n=172).According to the2016 ESC heart failure guidelines,CHF patients were divided into heart failure with preserved ejection fraction(HFp EF)group(n=58),heart failure with mildly reduced ejection fraction(HFmr EF)group(n=44),and heart failure with reduced ejection fraction(HFr EF)group(n=70)according to the left ventricular ejection fraction(LVEF)classification criteria.Patients in the CHF group were followed up for 6 months to determine whether they had Major adverse cardiovascular events(MACE),including acute coronary syndrome,cardiac death,and deterioration of cardiac function.The patients were divided into non-MACE group(n=130)and MACE group(n=42).In addition,non-CHF patients hospitalized during the same period were selected as the control group(n=60).2.During the period of hospitalization,the general data of all the selected patients were collected,including age,gender,history of risk factors,height,weight,etc.Fasting blood was collected in the morning of the next day of hospitalization,and routine biochemical indicators such as liver function,kidney function,blood lipids,and blood glucose were detected in the hospital.Plasma SPARC and TGF-β1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Color Doppler echocardiography was used to measure the left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),end-diastolic interventricular septum thickness(IVST),and left ventricular posterior wall thickness(LVPWT)in three consecutive cardiac cycles,and then the average value was calculated and then used to calculate the left ventricular mass index(LVMI).3.The above indexes were compared between the CHF group and the control group,the MACE group and the non-MACE group,and the differences of SPARC,TGF-β1,LVEF and LVMI between the CHF subgroups were analyzed.The correlation between SPARC and TGF-β1 in CHF patients and between Sparc and Tgf-β1 and LVEF,LVMI and LVEF classification were analyzed,and the risk factors of CHF patients and their poor prognosis were explored.The diagnostic value of SPARC,TGF-β1 and the combination of SPARC and TGF-β1 for CHF and the predictive value of SPARC and TGF-β1 for poor prognosis in patients with CHF were evaluated.Results:1.Compared with the control group,the CHF group was older,the prevalence of diabetes was higher,and the plasma levels of SPARC,TGF-β1,BNP,Cr,Hb Alc,AST and LVMI were higher;The levels of TC,TG,HDL,LDL and LVEF were significantly lower than those in the control group(P<0.05).There were no significant differences in gender,smoking history,hypertension prevalence,BMI and ALT between the two groups(P>0.05).2.The levels of SPARC and TGF-β1 in HFr EF group were significantly higher than those in HFp EF group(P<0.05),but there was no significant difference between HFmr EF group and HFr EF group,and between HFp EF group and HFmr EF group(P<0.05).The LVMI value of HFr EF group > HFmr EF group > HFp EF group,and the LVEF value of HFr EF group < HFmr EF group < HFp EF group,the differences were statistically significant(P<0.05).3.There was a positive correlation between plasma SPARC and TGF-β1 in CHF group.Plasma SPARC and TGF-β1 levels were positively correlated with LVMI and LVEF grade,and negatively correlated with LVEF value.4.Multivariate Logistic analysis of risk factors in CHF patients showed that high levels of SPARC,TGF-β1 and Cr,low levels of TC were independent risk factors for CHF patients.ROC curve analysis showed that the area under the curve(AUC)of plasma SPARC,TGF-β1,and SPARC+TGF-β1 in the diagnosis of CHF patients were 0.833,0.707,and 0.843,respectively,which all had certain diagnostic value,and the combination of the two had the highest diagnostic value.5.Analysis of poor prognosis of CHF patients: compared with the non-MACE group,the plasma HDL level in the MACE group was lower,and the plasma SPARC level was higher,the difference was statistically significant(P<0.05);There was no significant difference in other clinical data between the two groups(P>0.05).Multivariate Logistic risk factor analysis showed that both plasma SPARC and TGF-β1 levels could not be used as risk factors for poor prognosis of CHF,and only low level of HDL was an independent risk factor for poor prognosis of CHF.The predictive value analysis of poor prognosis of CHF patients showed that the area under the curve(AUC)of plasma SPARC and TGF-β1levels for predicting poor prognosis of CHF patients were 0.598 and 0.583,respectively,and the difference was not statistically significant,indicating that plasma SPARC and TGF-β1 levels had no predictive value for poor prognosis of CHF patients.Conclusions:1.The plasma levels of SPARC and TGF-β1 in CHF patients are increased,positively correlated with LVMI value and LVEF classification,and negatively correlated with LVEF value.The plasma levels of SPARC and TGF-β1 are positively correlated with LVMI value and LVEF classification,suggesting that to a certain extent,the plasma levels of Sparc and Tgf-β1 can reflect the severity of cardiac function and ventricular remodeling in CHF patients.It plays an important role in the occurrence and development of CHF.2.The increase of plasma SPARC,TGF-β1 and Cr levels and the decrease of TC level are independent risk factors for CHF patients.The combined detection of SPARC and TGF-β1 has a good diagnostic value for CHF.3.Plasma SPARC and TGF-β1 have no predictive value for the prognosis of CHF patients. |
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