Expressions Of ?₁AA And CTGF In Peripheral Blood Of Children With Dilated Cardiomyopathy And Its Clinical Significance

ObjectiveTo investigate the expressions of anti-?₁-adrenoceptor antibody??₁AA?and connective tissue growth factor?CTGF?in peripheral blood of children with dilated cardiomyopathy?DCM?and its clinical significance,we hope to look for new clinical alternative indicators to assess the severity of DCM.MethodsTwenty-seven patients diagnosed with DCM in acute phase were selected to be the DCM group.Twenty healthy subjects who attended physical examinations were chosen as healthy controls.All the children were from pediatrics of Shandong Provincial Hospital Affiliated to Shandong University between October 2015 and April 2016.We collected the medical records of all the children.The DCM group was scored according to modified Ross score as the referent criteria.The left ventricular end-diastolic diameter?LVEDD?and left ventricular ejection fraction?LVEF?of all the children were measured by cardiac ultrasound.Enzyme-linked immunosorbent assay?ELISA?was used to determine the levels of ?₁AA,CTGF,high-sensitivity troponin T?hs-TnT?and N-terminal pro-brain natriuretic peptide?NT-proBNP?in the serum of all the children.Results1.There were 27 cases in DCM group,10 boys and 17 girls.The ages ranged from 3 months to 14 years and the median age was 6 years.There were 20 cases in healthy control group,8 boys and 12 girls.The ages ranged from 7 months to 12 years and the median age was 6 years.There were no statistically significant differences between the two groups in gender and age?P>0.05?.2.Compared with healthy controls,?₁AA level,CTGF level and LVEDD value in DCM group were significantly increased[?224.80 ± 34.90?ng/L vs.?260.23 ± 34.03?ng/L,t=-3.49,P<0.01;?937.16 ±114.50?ng/L vs.?1223.44±190.85?ng/L,t=-5.95,P<0.01;?32.5]±5.95?mm vs.?53.02± 11.01?mm,t=-7.54,P<0.01]and the LVEF value was significantly decreased[?64.15±0.88?%vs.?28.15±7.34?%,t=21.74,P<0.01].3.Compared with DCM children of normal hs-TnT level,?₁AA level and CTGF level in DCM children of abnormal hs-TnT level were significantly increased[?233.56±8.3?ng/L vs.?269.56±34.78?ng/L,t=-2.68,P<0.05;?1070.76±86.87?ng/Lvs.?1276.88±189.38?ng/L,t=-2.75,P<0.05].4.The ?₁AA level and CTGF level were no statistically significant difference between different gender groups in DCM children[?252.78±27.18?ng/L vs.?264.60±37.57?ng/L,t=0.87,P>0.05;?1161.82±127.75?ng/Lvs.?1259.69±215.04?ng/L,t 1.30,P>0.05].5.The level of ?₁ AA in DCM group was positively correlated with the level of NT-proBNP,modified Ross score and hs-TnT?r=0.745,P<0.001;r=0.813,P<0.001;r=0.526,P=0.005?,negatively correlated with LVEF value?r=-0.646,P<0.001?,and not correlated with age?P>0.05?.6.The level of CTGF in DCM group was positively correlated with the level of NT-proBNP,modified Ross score and hs-TnT?r=0.798,P<0.001;r=0.823,P<0.001;r=0.753,P<0.001?,negatively correlated with LVEF value?r=-0.642,P<0.001?,and not correlated with age?P>0.05?.Conclusions1.The expressions of ?₁ AA and CTGF increase in peripheral blood of children with dilated cardiomyopathy,which shows that dilated cardiomyopathy is associated with autoimmune reaction and myocardial fibrosis.2.The expressions of ?₁ AA and CTGF are higher in peripheral blood of children with dilated cardiomyopathy of hs-TnT positive expression,which shows that the levels of ?₁ AA and CTGF are associated with myocardial injury.3.The expressions of ?₁ AA and CTGF in peripheral blood of children with dilated cardiomyopathy are positively correlated with the level of NT-proBNP and modified Ross score and negatively correlated with LVEF value,which shows that the levels of ?₁ AA and CTGF are associated with heart function.4.The levels of ?₁ AA and CTGF in children with dilated cardiomyopathy can represent the severity of the disease and can be used as new clinical reference indicators to assess the condition of children with dilated cardiomyopathy.