| Objective: To discuss serum level changes of pentraxin-3(PTX-3) in patients withchronic heart failure (CHF),compare PTX-3with clinical evaluation for chronic heartfailure (CHF) such as high-sensitivity C-reactive protein (hs-CRP) and N-terminalpro-brain natriuretic peptide (NT-proBNP), and analysis different roles of the abovemarkers in evaluation the cardiac function in patients with CHF.Methods: We selected87patients (40males,47females) from120patients whowere successively admitted into the Department of Cardiovascular Medicine of theSecond Affiliated Hospital of Dalian Medical University during the period from July2011to March2012and diagnosed as HF patients according to Framingham criteria forHF. Meanwhile, we collected their personal data (including age, sex, smoking history,BMI, medical history of hypertension, medical history of diabetes, ECG, etc.) andconducted laboratory examination for their fasting blood-glucose (FBG), triglyceride(TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high densitylipoprotein-cholesterol (HDL-C), hs-CRP, NT-proBNP, ECG and UCG. These patientswere divided into different groups according to left ventricular ejection fraction (LVEF)of UCG: the group with normal systolic function (LVEF≥40%)(38patients) and thegroup with systolic dysfunction (LVEF＜40%)(49patients); compared the difference ofPTX-3, hs-CRP and NT-proBNP levels in two groups. According to the criteria of NewYork Heart Association (NYHA) for heart function classification, we divided thepatients into control group (NYHA Class I,10patients), NYHA Class II group (24patients), NYHA Class III group (36patients) and NYHA Class IV (27patients), andcompared the difference between different NYHA Class groups in serum PTX-3,hs-CRP and NT-proBNPdifference. we compared the difference between different causeof CHF patients of PTX-3difference。Were observed the relevance PTX-3and hs-CRP levels between PTX-3and NT-proBNP levels in CHF patients. we analyzed andcompared diagnostic heart failure of the sensitivity and specificity between PTX-3,hs-CRP and NT-proBNP levels by use of LVEF and ROC curve。Results:1. The group with systolic dysfunction was higher than the group with normalsystolic function in serum PTX-3, hs-CRP and NT-proBNP levels, which wererespectively3.68±0.83vs.3.20±0.64ng/ml,5.90±2.18vs.3.62±2.41mg/L,3536.10±1398.62vs.2361.18±779.78pg/ml, and the difference was statisticallysignificant (P＜0.05).2. Comparison between different NYHA Class groups of CHF patients in serumPTX-3, hs-CRP and NT-proBNP levels: serum PTX-3, hs-CRP and NT-proBNP levelsall increased along with the increase in NYHA Class of heart function. PTX-3levelswere respectively:2.60±0.37ng/ml (control group),2.72±0.70ng/ml (NYHA Class IIgroup),3.13±0.66ng/ml (NYHA Class III group),4.04±0.51ng/ml (NYHA Class IVgroup). hs-CRP levels were respectively:2.95±1.74mg/L (control group),5.22±2.97mg/L(NYHA Class II group),7.32±4.52mg/L(NYHA Class III group),11.19±5.46mg/L(NYHA Class IV group). NT-proBNP levels were respectively:1037.65±456.11pg/ml (control group),2320.67±878.36pg/ml (NYHA Class II group),3548.92±1396.63pg/ml (NYHA Class III group),4893.59±1965.89pg/ml (NYHA ClassIV group),and the difference was statistically significant (P＜0.05).3. Comparison between different primary disease groups of CHF patients in serumPTX-3levels: ischemic heart disease (3.06±1.11ng/ml), hypertensive heart disease(3.05±0.44ng/ml), dilated cardiomyopathy (3.61±0.17ng/ml). and the difference was nostatistical difference (P＞0.05).4. Linear regression analysis: serum PTX-3was positively correlated to hs-CRP(r=0.251, P＜0.05), and was negatively correlated to NT-proBNP (r=0.238, P＜0.05).5. Comparison in diagnosis of heart insufficiency sensitivity and specificity betweenserum PTX-3, hs-CRP and NT-proBNP by use of LVEF and ROC curve: ROC curveanalysis showed that PTX-3AUC (area under the ROC curve) was0.72, optimal cutoffvalue was3.18ng/ml, related sensitivity and specificity were respectively79.6%and64.8%; hs-CRP AUC was0.64, optimal cutoff value was4.84mg/L, related sensitivityand specificity were respectively62.6%and56.4%; NT-proBNP AUC was0.70,optimal cutoff value was2810.35pg/ml, related sensitivity and specificity wererespectively70.6%and60.9%. Conclusion:1. Serum PTX-3level remarkably increased in the group with systolic dysfunction,and also increased along with the increase in NYHA Class of heart function.2. Serum level of PTX-3was superior to NT-proBNP in evaluation for cardiacfunction of sensitivity and specificity in patients with CHF, and could be used as newevaluation index for left ventricular systolic dysfunction. |
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