Correlation Between Plasma ALD,sST2 And Ventricular Remodeling In Patients With Heart Failure

Objective:Detection of plasma aldosterone(ALD),N-terminal pro brain natriuretic peptide(NT-proBNP),soluble stromelysin 2(sST2)levels in patients with heart failure(HF).The left ventricular mass index(LVMI)was calculated,and the trends of plasma ALD,NT-proBNP,and sST2 concentrations in patients with different types of HF and their correlation with ventricular remodeling were analyzed.Methods:From April 2021 to September 2021,126 patients with HF in the Cardiovascular Inpatient Department of the Affiliated Hospital of North Sichuan Medical College were collected as research subjects.According to the "2016 ESC Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Failure" They were HFrEF group(EF<40%,n=48),HFmEF group(40%≤EF<50%,n=22),and HFpEF group(EF≥50%,n=56).Results:1.There were significant differences in gender and age ratio between the study groups(P<0.05).The proportion of female patients in HFpEF group was significantly higher than that in HFmEF and HFrEF groups;the age of HFpEF patients(71.88±9.01)was greater than that of HFmEF patients(68.50±12.34)and HFrEF patients(66.70±10.13),and the difference was statistically significant(P<0.05).There was no significant difference between the age of HFmEF patients(68.50±12.34)and HFrEF patients(66.70±10.13)(P>0.05).2.Through univariate variable analysis,the indexes of different groups were compared.The results showed that there were significant differences in LVMI,plasma ALD,NT proBNP and sST2 concentrations among the groups(P<0.05):①The ALD level of HFpEF group was significantly lower than that of HFmEF group(P<0.05),and the ALD level of HFmEF group was significantly lower than that of HFrEF group(P<0.05);②The plasma NT-proBNP levels in the HFpEF group were significantly lower than those in the HFmEF group and the HFrEF group(P<0.05),and the plasma NT-proBNP levels in the HFmEF group and the HFrEF group were not statistically significant(P>0.05);③The level of plasma sST2 in HFpEF group was significantly lower than that in HFmEF group and HFrEF group(P<0.05).There was no significant difference between HFmEF group and HFrEF group(P>0.05);④The LVMI level of HFpEF group was significantly lower than that of HFmEF group(P<0.05),and the LVMI level of HFmEF group was significantly lower than that of HFrEF group(P<0.05).3.The Spearman method was used to analyze the correlation of plasma ALD,NT-proBNP and sST2 levels with LVMI in patients with different types of HF.①In the HFpEF group,there was a positive correlation between the plasma ALD level and LVMI(rs=0.538,P<0.05),the plasma sST2 concentration level and LVMI were positively correlated(rs=0.551,P<0.05),the plasma sST2 and ALD were positively correlated(rs=0.551,P<0.05).②In HFmEF group,there was a positive correlation between plasma ALD concentration and LVMI(rs=0.672,P<0.05),no significant correlation between plasma ST2 concentration and LVMI(P>0.05),and no significant correlation between plasma ST2 and ALD concentration(P>0.05);③In the HFrEF group,there was a positive correlation between the plasma ALD concentration and LUMI(rs=0.668,P<0.05),and the plasma sST2 and LVMI were positively correlated(rs=0.345,P<0.05),There was a positive correlation between plasma sST2 and ALD levels(rs=0.515,P<0.05);④There was no significant correlation between plasma NT-proBNP concentration and LVMI in patients with different types of HF(P>0.05).4.Spearman method was used for correlation analysis.The results showed that there was a negative correlation between plasma ALD,sST2 concentration and EF in patients with different types of HF:①in HFpEF group,there was a negative correlation between plasma ALD and EF(rs=-0.712,P<0.05),and between plasma ST2 and ef(rs=-0.789,P<0.05);②In HFmEF group,plasma ALD was negatively correlated with EF(rs=-0.553,P<0.05),and plasma sST2 was negatively correlated with EF(rs=-0.825,P<0.05);③In HFrEF group,plasma ALD was negatively correlated with EF(rs=-0.789,P<0.05),and plasma ST2 was negatively correlated with EF(rs=-0.710,P<0.05).Conclusion:1.HEpEF population has obvious gender and age correlation,in which the proportion of female and elderly patients increases significantly.2.The plasma levels of ALD and sST2 in patients with different types of HF were negatively correlated with their EF.The correlation between plasma ALD and EF was stronger in HFrEF group,and the correlation between plasma sST2 and EF was stronger in HFpEF group.3.There was a significant positive correlation between plasma ALD level and LVMI in patients with different types of HF;There was a significant positive correlation between plasma sST2 levels and LVMI in patients with HEpEF and HErEF.4.Plasma ALD has a greater impact on ventricular remodeling in patients with HFrEF,and plasma sST2 has a greater impact on ventricular remodeling in patients with HFpEF.5.The study of heart failure and ventricular remodeling markers in HFpEF patients is a hot spot in this field.Although our study found that the correlation between sST2 and ventricular remodeling in HFpEF patients is higher than that in HFrEF patients,it still needs more further research as a marker of ventricular remodeling in HFpEF patients.