| Objective: To investigate the correlation between serum cystatinC(Cys C)levels and heart failure with ejection fraction retention(HFpEF),making it a sensitive indicator for a more effective early diagnosis of HFpEF and the assessment of therapeutic outcome.Methods: 100 patients diagnosed as HFpEF in the Department of Cardiology,People's Hospital of China Medical University from October 2018 to October 2019 were selected as the HFpEF group,depending on the underlying heart disease,36 patients with coronary atherosclerosis,hypertensive heart disease patients with 41 cases,9 cases of hypertrophic cardiomyopathy patients,8 patients with type 2 diabetes,6 patients with pulmonary hypertension.According to different grades of diastolic dysfunction,there were 44 cases of grade I,43 cases of grade II and 13 cases of grade III in HFpEF group.A total of 100 healthy physical examinees from the same hospital were selected as the control group.General clinical data were collected for all patients: age,gender;All lines of echocardiography(UCG)collect ultrasonic parameters:Left atrium diameter(LAD),Left ventricular ejection fraction(LVEF),Peak early diastolic mitral inflow velocity(E),Peak late diastolic mitral inflow velocity(A),early mitral valve ring diastolic movement velocity,Left atrial maximum volume index,Tricuspid regurgitation(TR)peak flow velocity.All collect serological indexes: serum Cys C,N-terminal pro-brian nitric peptide(NT-proBNP),High-sensitive cardiac troponin T(hs-cTnT),Creatine kinase isoenzymes MB(CK-MB),serum Creatinine(Cr).Used in this study SPSS23.0 as statistical analysis software,the research on data analysis and found patients data conforms to the standard normal distribution,measuring data,said in the form of the average±standard deviation between the comparison between the groups were divided into groups and between groups,the former use independent sample t-test,comparison between multiple sets of using single factor ANOVA analysis of variance,between two groups to compare using LSD test,on each index in the group HFpEF Pearson correlation analysis,and through the partial correlation analysis of correction factors,comparing the real correlation among various factors,in order to P<0.05 for the difference was statistically significant.Results: 1.There was no significant difference between the HFpEF group and the control group in gender,age,serum hs-cTnT,serum CK-MB,serum Cr and LVEF(P>0.05).However,serum Cys C(1.14 ± 0.27)mg/L and NT-pro BNP(699.27 ±1049.58)pg/mL in HFpEF group were higher than those in control group(0.69 ±0.29)mg/L and(50.89±26.26)pg/mL,with statistically significant differences(P<0.05).2.There was no significant difference in gender,serum hs-cTnT,serum CK-MB,serum Cr level and LVEF between HFpEF grades and the control group(P>,0.05).The age of HFpEF was 60.05±10.34 years old in grade I,68.16±10.68 years old in grade II,and 74.69 ± 6.87 years old in grade III,respectively.The results of serum Cys C levels in the control group and HFpEF grades were 0.69±0.29 mg /L,grade I(1.05± 0.22)mg/L,grade II(1.18 ± 0.21)mg/L,and grade III(1.37 ± 0.22)mg/L,respectively.The results of serum NT-proBNP level in the control group and different HFpEF grades were 50.89 ± 26.26 pg/mL,grade I(326.95 ± 352.85)pg/mL,grade II(779.54 ± 1200.73)pg/mL,and grade III(1693.92 ± 1411.71)pg/mL,respectively.Moreover,age,serum CysC level and serum nt-probnp level were pantwise compared among different HFpEF grading groups,and the differences were statistically significant(P<0.05).With the increase of HFpEF classification,age,serum CysC level and NT-proBNP level all increased gradually.3.In the HFpEF group,age was positively correlated with HFpEF classification(r=0.462,P<0.05).Serum CysC level was positively correlated with HFpEF classification(r=0.449,P<0.05).Serum NT-proBNP level was positively correlated with HFpEF classification(r=0.408,P< 0.05).The correlation between LVEF and HFpEF was negative(r=-0.267,P< 0.05).There was no correlation between serum Cr level and HFpEF grading(r=-0.200,P>0.05).There was no correlation between serum hs-cTnT level and HFpEF grading(r=0.027,P>0.05).There was no correlation between serum CK-MB level and HFpEF grading(r=0.054,P>0.05).The serum Cys C level was positively correlated with the serum NT-pro BNP level(r=0.303,P<0.05).Partial correlation analysis results showed that there was no positive correlation between serum Cys C level and serum NT-proBNP level(partial correlation coefficient was 0.148,P>0.05).Therefore,HFpEF classification is positively correlated with age,serum CysC level and serum NT-proBNP level.There was a negative correlation between HFpEF classification and LVEF.There was nocorrelation between HFpEF grading and serum Cr,serum hs-cTnT level and serum CK-MB level,while there was no correlation between serum Cys C level and serum NT-proBNP.Conclusion: 1.Serum Cys C level combined with serum NT-proBNP level can be used to assist the diagnosis of HFpEF.2.For patients diagnosed with HFpEF,disease severity can be evaluated according to age,LVEF,serum CysC level and serum NT-pro BNP level.The older the patient is,the higher the serum CysC and NT-proBNP level is,the higher the HFpEF grade is,and the more serious the heart failure condition is. |
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