| Objective: Study on the correlation between changes in plasma levels of galectin-3(Gal-3)and transforming growth factor β1(TGF-β1),H2 relaxin(H2RLX)in patients with chronic heart failure(CHF),Identifying factors affecting Gal-3 levels and its value in assessing the prognosis of heart failure,and explore the effect of three on myocardial fibrosis(MF),provide a theoretical basis for the study of the pathogenesis and clinical treatment of CHF patients.Methods: 88 cases of CHF patients admitted to Department of Cardiology in Affiliated Hospital of Jining Medical College from December 2014 to December 2015 were selected as the heart failure group,all patients met the inclusion criteria.and according to the NYHA heart function classification,24 cases of cardiac function grade II,38 cases of cardiac function grade III,26 cases of cardiac function grade IV,were selected at the same period of at our hospital physical examination of 40 cases as the normal control group.The levels of Gal-3,TGF-β1 and H2 RLX were measured by enzyme-linked immunosorbent assay(ELISA),the correlation between the levels of Gal-3,TGF-β1,H2 RLX and NYHA classification was analyzed by Spearman rank correlation,the left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)were measured by echocardiography,the correlationbetween the levels of Gal-3,TGF-β1,H2 RLX and LVEF,LVEDD was analyzed,and the correlation in Gal-3,TGF-β1 and H2 RLX by Pearson correlation,the establishment of plasma Gal-3 multivariate model in patients with CHF was analyzed by multivariate stepwise regression analysis.Calculate the rate of readmission and fatality in 88 patients with CHF through the follow-up in one year,the correlation between the levels of Gal-3,readmission rate and fatality rate was analyzed by Spearman rank correlation.Results:1.There is no significant difference of the plasma levels of Gal-3,TGF-β1,H2 RLX among different causes of heart failure groups(p>0.05).2.The plasma levels of Gal-3,TGF-β1 and H2 RLX in patients with the heart failure group were significantly higher than those in the normal control group(t=7.383,t=9.113,t=8.678,P<0.05);The results of comparison of LSD between the grade III,IV and II showed that,there were significant differences in the levels of plasma Gal-3,TGF-β1 and H2 RLX in patients(P<0.05),Spearman rank correlation analysis showed that plasma Gal-3,TGF-β1,H2 RLX levels were positively correlated with NYHA classification(r=0.642,r=0.736,r=0.623,P< 0.05).3.Pearson correlation analysis showed that plasma levels of Gal-3,TGF-β1 and H2 RLX in patients with the heart failure group we re negatively correlated with LVEF(r=-0.466,r=-0.467,r=-0.436,P<0.05),and positively correlated with LVEDD(r=0.487,r=0.489,r=0.475,P<0.05).Gal-3 was positively correlated with TGF-β1 and H2RLX(r=0.852,r=0.820,P<0.05),TGF-β1 was positively correlated with H2RLX(r=0.830,P<0.05).4.Taking Gal-3 as dependent variable,the TGF-β1、H2RLX、LVEF、LVEDD、BNP、TC、TG、LDL、HDL were included in the independent variables,and multiple stepwise regression analysis was performed,Regression equation:Y=-1.602+0.509(TGF-β1)+0.312(H2RLX)+0.160(BNP).5.The patients with the heart failure group were divided into hi gh-Gal-3 group(40 persons)and low-Gal-3 group(48 persons)accord ing to Gal-3 mean 254.44pg/ml for the community,the readmission rate was 42.5%,and fatality rate was 27.5% in high-Gal-3 group,sig nificantly higher than 20.8% and 10.4% in low-Gal-3 group in one year(P<0.05).Spearman rank correlation analysis showed that plasm a Gal-3 was positively correlated with the rate of readmission and f atality(r=0.234,r=0.221,P<0.05).Conclusion:1.The plasma levels of Gal-3,TGF-β1 and H2 RLX were increa sed in patients with CHF,and associated with the grade of cardiac function,all three can be used as an index to judge the severity of CHF.2.The plasma level of Gal-3 can predict the readmission rate and fatality rate in patients with CHF,which can be used to evaluate the prognosis of patients with CHF.3.TGF-β1,H2 RLX,BNP were independent relevant factors to affect the plasma levels of Gal-3 in patients with CHF.4.There was a correlation between plasma levels of Gal-3,TGF-β1 and H2 RLX in patients with CHF,which had an influence on t he occurrence and development of MF,and participated in the path ophysiological process of CHF. |
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