| Objective: Chronic Heart Failure is the final stage of a variety of cardiovascular diseases and the most frequent cause of sudden cardiac death(SCD). Ventricular Arrhythmias, especially frequent premature ventricular contraction(PVCs),non-sustained ventricular tachycardia(NSVT), sustained ventricular tachycardia(VT)and ventricular fibrillation(Vf), are believed to be the main cause of SCD in the patients of chronic heart failure. Domestic and foreign researches found that myocardial fibrosis and myocardial scar were considered as a potential pathological basis of life-threatening ventricular arrhythmias. The aim of this study was to evaluate the correlation between ventricular arrhythmias and serum Procollagen Type ⅢN-Terminal Peptide(PⅢNP)in patients with chronic heart failure.Methods: 240 patients entered the study, which were admitted to the Department of Heart Failure, the 2nd Affiliated Hospital of Dalian Medical University from January2014 to February 2015. The subjects were divided into CHF group(n=180) and control group(n=60). The patients with CHF were divided into MVA subgroup(n=88) and no MVA subgroup(n=92) according to the results of 24-hour ambulatory electrocardiogram(Holter). The MVA is refrred to PVCs that is defined as the number of premature ventricualr contraction is more than 6 times per minute or more than 30 times per hour, NSVT, sustained VT and Vf. The CHF patients were divided into negative(PⅢNP≤30ng/ml), mild elevation(30 < PⅢNP ≤ 60ng/ml)and severe elevation( P Ⅲ NP>60ng/ml)subgroups according the level of P Ⅲ NP. The level of B-typenatriuretic peptide(BNP) of all patients was detected on the day of admission and the level of PⅢNP of all patients was detected in the morning following an overnight fast. Left ventricular end-diastolic diameter(LVEDD) and 1eft ventricular ejection fraction( LVEF) were measured by using color Doppler ultrasound. The difference of the level of P Ⅲ NP was investigated between each group. And the correlation was analyzed among the levels of PⅢNP and BNP, LVEDD, LVEF, PVCs respectively. The difference of frequency of NSVT was investigated among negative, mild elevation and severe elevation subgroups according to PⅢNP. Multivariate- Logistic regression was analyzed to figure out risk factors of MVA in patients with chronic heart failure. SPSS17.0 software package was used for statistical analyses.Results:1. The level of P Ⅲ NP was significantly higher in CHF group than in control group(P<0.05), and the level of PⅢNP was positively correlated with LVEDD and negatively correlated with LVEF in CHF patients(r=0.262, P<0.001 and r=-0.232,P=0.002 respectively). But it was not correlated with BNP(P>0.05).2. The incidence rate of MVA was 48.8% in CHF patients. The levels of PⅢNP,BNP and LVEDD were significantly higher in MVA subgroup than in the no MVA subgroup respectively(P<0.05, respectively), the level of LVEF was significantly lower in MVA subgroup than in the no MVA subgroup(p<0.001).3. The level of PⅢNP was positively correlated with the number of PVCs in the patients with CHF(r=0.225, P<0.05). The frequency of NSVT showed statistical significance among negative, mild elevation and severe elevation subgroups according to PⅢNP(P<0.05, respectively).4. P Ⅲ NP and LVEDD were risk factors of MVA in patients with CHF.(OR=1.056, P=0.000 and OR=1.105, P=0.006 respectively).Conclusion : 1. The level of P Ⅲ NP was elevated in patients with CHF, which indicated the amount of collagen was increased and might reflect ongoing myocardial fibrosis in patients with CHF. The level of PⅢNP was higher in MVA subgroup, which indicated the more serious myocardial fibrosis in CHF patients complicated with MVA.2. The level of P Ⅲ NP was positively correlated with the number of PVCs inpatients with CHF. The frequency of NSVT was higher as the increasing of PⅢNP level,These showed PⅢNP might be used as a predictive factor of MVA.3. PⅢNP could be used as a risk factor of MVA in patients with CHF. |
