Clinical Significance Of Serum P?NP And Soluble ST2 In Chronic Heart Failure

Objective: Chronic Heart Failure(CHF)is a pathological condition that cardiac output can't maintain the normal metabolic needs of the tissue,mainly because of cardiac systolic or diastolic dysfunction,leading to reduced cardiac output.Its clinical manifestations include the congestion in pulmonary and systemic circulation.It is generally accepted that the core mechanism of heart failure is ventricular remodeling,which has a decisive effect on morbidity and mortality in the patients with heart failure.Myocardial Fibrosis(MF)is the main cause of ventricular remodeling,which is manifested in the increased extracellular matrix(ECM)collagen deposition.Procollagen type ? N-terminal peptide(P?NP),that acts as a circulating marker of type ? collagen metabolism,is generated by type ?collagen in the equal proportion.So P?NP can indirectly reflect the synthesis state of type ? collagen,thus reflecting the severity of tissue and organ fibrosis.Growth stimulation expression gene 2 is abbreviated asST2,whose gene mainly expresses transmembrane form ST2 and serum solubleST2(sST2).sST2,as a new cardiovascular marker,may be related to the severity of heart failure and cardiac function damage,and involved in the process of myocardial fibrosis and ventricular remodeling.In this study,serum P?NP and sST2 were determined in the patients with heart failure,who were hospitalized in the 2nd Affiliated Hospital of Dalian Medical University.In addition,by exploring the relationships between cardiac function parameter and either of them,and observing the association between the two indicators,their clinical significance for the diagnosis and prognosis evaluation can be evaluated.Materials and Methods: A total of 149 patients who were hospitalized in the 2nd Affiliated Hospital of Dalian Medical University from May,2016 to January,2017 were divided into CHF group(n = 97)and control group(n =52).Peripheral venous blood was taken from all the patients on the day of admission,and then the serum was separated,and preserved in low temperature for the determination of sST2.Besides,the level of N-terminal pro-brain natriuretic peptide(NT-pro BNP)was measured on the sane day.The level of P?NP was measured in the next morning on an empty stomach.the correlation analysis were made for exploring the relationship between P?NP,sST2 and NT-pro BNP,LVEDD,LVEF.SPSS 22.0 statistical software package was used for statistical analysis.Results: 1.The level of P? NP in CHF patients is significantly higher than that in the control group(p < 0.01);the level of P? NP in CHF patients is positively correlated with NT-pro BNP and LVEDD(r = 0.359,p <0.001;r=0.270,p=0.008,respectively),and negatively correlated with LVEF(r =-0.251,p = 0.013).2.The level of sST2 in CHF patients is significantly higher than in the control group(P <0.01);the level of sST2 in CHF patients is positively correlated with NT-pro BNP and LVEDD(r = 0.464,p <0.001;r = 0.421,p<0.001,respectively),and negatively correlated with LVEF(r =-0.404,p<0.001).3.There is a significant positive correlation between P ? NP and sST2 in CHF patients(r = 0.293,p = 0.004).Conclusions: 1.The level of P ? NP in patients with heart failure is increased significantly,and with the deterioration of cardiac function,P?NP level were higher,indicating that MF level may be severer.2.The level of sST2 in patients with heart failure is significantly increased,and with the deterioration of cardiac function,sST2 level is higher,suggesting that sST2 may reflect the severity of heart failure.3.There is a positive correlation between serum P?NP and sST2 level in patients with heart failure,indicating that sST2 may be helpful in evaluating the degree of MF in patients with heart failure.