Clinical Value Of High Sensitive Cardiac Troponin T,High Sensitive C Reactive Protein,Growth Differentiation Factor-15 And N-terminal Pro-brain Natriuretic Peptidein In Patients With Heart Failure

ObjectiveTo explore the clinical value of serum high sensitive troponin T(hs-cTnT),high sensitive C-reactive protein(hs-CRP),growth differentiation factor-15(GDF-15)and N-terminal pro-brain natriuretic peptidein in patients with different heart failure.MethodsOne hundred and twenty-six patients with heart failure who were hospitalized in our hospital from January 2014 to April 2016 were selected as the heart failure group.Eighty-nine patients without heart disease in the same hospital were selected as the control group during the same period.The levels of serum hs-cTnT were measured by the method of micro particle chemiluminescence.The level of serum high sensitive C-reactive protein(hs-CRP)was detected by immune assay.The serum GDF-15 was detected by enzyme linked immunosorbent assay(ELISA).The plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)was detected by immunofluorescence.Left ventricular end-diastolic left ventricular diameter(LAd),left ventricular end-diastolic diameter(LVEDd),left ventricular end-diastolic dimension(LVESd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)and left ventricular ejection fraction(LVEF)were measured by echocardiography.The levels of serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP,LAd,LVEDd,LVESd,IVST,LVPWT and LVEF in patients with heart failure disease were divided into different subgroups according to different classification.And the correlations among the indexes in each subgroup were analyzed.The predictive value of hs-cTnT,hs-CRP,GDF-15,NT-proBNP in patients with heart failure in one years were analyzed using the receiver operating characteristic curve(ROC)curve.Results1.In the heart failure group,The serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP,LAd,LVEDd,LVESd,IVST and LVPWT were significantly higher than the control group,but the index of LVEF was lower than the control group,there was significant difference between the two groups(P<0.05).2.In the heart failure group,the serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP level were negatively correlated with LVEF(r=-0.553;-0.358;-0.659;-0.813,P<0.05).3.The levels of serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP in HFPEF group were lower than the HFREF group,the index of LAd,LVEDd,LVESd diameter were lower than the HFREF group,and the indexes of IVST,LVPWT diameter were higher than that of patients in the HFREF group,there were significant difference between the two groups(P<0.05).4.With the level of heart function classification increased,the levels of serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP and the index of LAd,LVEDd were significantly increased,while LVEF decreased significantly,there is significant difference between the two groups(P<0.05).5.With heart failure classification for ischemic heart failure and non ischemic heart failure,the serum levels of hs-cTnT,hs-CRP,GDF-15,NT-proBNP,Lad,LVEDd,LVESd,IVST,LVPWT,LVEF had no statistical significance in the two groups(P>0.05).6.The ROC curve analysis showed the area under the ROC curve of the hs-CRP,hs-cTnT,GDF-15,NT-proBNP levels diagnosed to determine the patient re-hospitalization rate within one year were(0.671;0.786;0.803;0.897,P<0.05).The above indicators have high sensitivity and specificity.ConclusionThe levels of serum hs-cTnT,hs-CRP,GDF-15,NT-proBNP in patients with heart failure were positively correlated with the severity of heart failure symptoms,negatively correlated with ventricular function,and had no correlation with the cause of heart failure.The above indicators have a certain predictive value for the occurrence of rehospitalization within one year.