| Background and ObjectiveHeart failure is the main death cause of cardiovascular disease on a global scale,also is a major health problem in human society.Compared with the advanced malignant tumor,the morbidity of heart failure,hospitalization rate and mortality is higher,particularly in elderly patients.Heart failure in patients with an average life expectancy is about 5.5 years.For age?65-year-old patients with chronic heart failure,the mortality is about twenty-five percent to fifty-two point nine percent.As a result,chronic heart failure is a global healthy care problem.Chronic heart failure is the end period of all kinds of cardiac disease.Ventricular remodeling is the important pathophysiological basis in progress of heart failure as people do research into chronic heart failure.The study found that Semaphorin 4D is a type I transmembrane glycoprotein molecule,which mainly expressed in T cells,B cells,platelets,endothelial cells,myocardial etc.Under the stimulation of various inflammatory factors,Sema4 D on cell surface is activated,called soluble Semaphorin4 D,which can blind to its receptor plexin-B1,the downstream of the related signaling molecules is phosphorylated through the structure of the cell surface Met tyrosine kinase.it can involved in angiogenesis,collagen fibrosis formation,thrombosis and atherosclerotic disease.Matrix metalloproteinases-14,or membrane-type 1 matrix metalloproteinases,is a matrix metalloproteinases subfamily member,expressed on the cell membrane in the form of actived enzyme,and participate in the myocardiac fibrosis and the development of heart failure,can degrade ? and ? type collagen,and fibronectin of the extracellular matrix.Studies have shown that Sema4 D can become a soluble Sema4 D in the role of the membrane-type 1 matrix metalloproteinases,and play thecorresponding biological function.So far,studies about the relationship between the sSema4 D and MMP14 are still rare.Study has found that sSema4 D and MMP14 in patients with heart failure elevated,but the relationship between the sSema4 D and MMP14 and the ventricular remodeling in elderly patients with heart failure has not been reported.This article will investigate the correlation between sSema4 D and MMP14 with ventricular remodeling in elderly patients with chronic heart failure.By detecting the level of serum sSema4 D and MMP14 in elderly patients with chronic heart failure,and observing the indexs related to echocardiography,to provide new therapeutic targets for chronic heart failure.MethodsFrom August 2014 to December 2015,116 patients with chronic heart failure were enrolled in geriatric cardiology of the First Affiliated Hospital of Zhenzhou University.in which,32 patients with dilated cardiomyopathy,49 patients with chronic heart failure,35 patients with atrial fibrillation.According to the NYHA grading,they were divided into heart function class II groups(n=28),heart function class III groups(n=58),heart function class IV group(n=30).35 healthy subjects in the first Affiliated hospital of Zhengzhou University outpatient care division as normal conerol group.Enzyme linked immunosorbentassay was used to detect the level of serum sSema4D?MMP14?pro-BNP and hs-CRP.Parameters including LAD?RVD?LVEF?LVEDD and LVFS were measured by echocardiography.Statistical analysis was performed using SPSS21.0 software,the measurement data is expressed inx±S,T test was used to compare the two groups.Single factor analysis of variance was used to compare the differences between groups.Bonferroni method was used for comparison between the two groups.Simple linear correlation analysis was performed by Pearson method.Multivariate correlation analysis using multiple regression analysis.With P<0.05 as the test standard,the difference was statistically significant.Result1.Cardiac function in chronic heart failure group class II?III?IV,the level of serum sSema4D?MMP14?pro-BNP is higher than normal control group(F=175.496?325.862?77.403,P<0.001),and compare the different classification of cardiac function between the two groups,the difference was statistically significant(P<0.05).2.The level of serum sSema4D?MMP14?pro-BNP in patients with chronic heart failure was higher than that in the normal controlgroup(t=15.65?28.95?34.54,P<0.001),and the levels of the three groups before treatment were higher than those in the treatment group(t=7.95?26.64?22.82,P<0.05),the difference was statistically significant(P<0.05).3.Compared with the control group,the LVDd?LAD?RVD of the patients with chronic heart failure was higher(t=22.43?18.83?3.34,P<0.01),LVEF?LVFS was lower than that of the normal control group(t=-38.23 ?-29.40,P < 0.001),the difference was statistically significant(P<0.05).4.There was no significant difference in serum sSema4D?MMP14?pro-BNP level between DCM?CHD and AF groups(F=0.243?0.247?0.284,P>0.05).5.Multivariate regression analysis showed that plasma sSema4 D ? MMP14 ?pro-BNP had significant effects on left ventricular end diastolic diameter(P <0.05),but the effect on pro-BNP is not statistically significant(P > 0.05).and serum sSema4 D had the largest contribution to the left ventricular end diastolic diameter enlargement(?=0.268,P=0.019),MMP14(?=0.234,P=0.037).6.The correlation analysis results show that the expression level of sSema4 D and MMP14 were positively correlated(r=0.462,P < 0.05).sSema4 D and the left ventricular end-diastolic diameter ? pro-BNP were positively correlated(r=0.643 ?0.464,P<0.001),MMP14 and the left ventricular end-diastolic diameter?pro-BNP were positively correlated(r=0.541?0.365,P<0.001),and negatively correlated with left ventricular ejection fraction(r=-0.462,P<0.001).Conclusions1.The level of serum sSema4 D and MMP14 elevates in chronic heart failure.2.Serum sSema4 D in elderly patients with chronic heart failure,was positively correlated with MMP14 protein level and left ventricular end diastolic diameter.3.Serum sSema4 D may be associated with ventricular remodeling in chronic heart failure.4.Serum sSema4 D and MMP14 is a risk factor for chronic heart failure;or can become a new target for the treatment of chronic heart failure. |
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