| Objective:To observe the changes of serum levels of vascular endothelial growth factor-C(VEGF-C),stromal cell-derived factor-1(SDF-1),sphingosine 1-phosphate(S1P)in patients with heart failure(HF)and different degrees of heart function,and to evaluate their diagnostic significance for heart failure.Methods:Eighty patients with heart failure hospitalized in department of cardiovascular medicine,first affiliated hospital of nanchang university were selected for echocardiographic examination.According to the classification criteria of Chinese Guidelines for Diagnosis and Treatment of Heart Failure 2018,HF patients were divided into three groups: heart failure with reduced ejection fraction(HFrEF,23 cases),heart failure with intermediate ejection fraction(HFmrEF,17 cases)and heart failure with preserved ejection fraction(HFpEF,40 cases).Forty-six patients with normal cardiac function in the same period were taken as control group.The levels of vascular endothelial growth factor-C,SDF-1 and S1 P were measured in all subjects.Results:1.The levels of SIP,SDF-1 and VEGF-C in the heart failure group were significantly lower than those in the control group(P < 0.05).Compared with HFpEF and HFmrEF,the levels of SIP and SDF in HFrEF group were lower(P < 0.05),and the difference was statistically significant.There was no significant difference in the levels of VEGF-C between HFpEF,HFmrEF and HFrEF groups(P > 0.05).There was no significant difference in the levels of SIP and SDF between HFpEF and HFmrEF groups(P > 0.05).2.Compared with the control group,the uric acid(URIC),homocysteine(HCY),left atrial anteroposterior diameter(LAD),left ventricular end diastolic diameter(LVEDD),mitral annular velocity ratio(E/e'),N-terminal pro-brain natriuretic peptide(NT-proBNP)values in HFpEF group were higher than those in the control group,while the value of high density lipoprotein(HDL),left ventricular ejection fraction(LVEF%)was lower than that of control group,and the difference was statistically significant(P < 0.05);the value of uric acid,HCY,LAD,LVEDD,E/e',NT-proBNP in HFmrEF group was higher than that of control group,while the value of HDL and LVEF% was lower than that of control group,and the difference was statistically significant(P < 0.05);the value of uric acid,HCY,LAD,LVED,E/e',NT-proBNP in HFrEF group was higher than that of control group,and the value of HDL and LVEF% was lower than that of control group.The difference was statistically significant(P < 0.05).3.Correlation analysis: Serum SIP,SDF-1 and VEGF-C levels were positively correlated with HDL and LVEF% values(P < 0.05),negatively correlated with LAD,LVEDD and E/e'(P < 0.05).SDF-1 was positively correlated with SIP(p < 0.05),and VEGF-C was positively correlated with SIP and SDF-1(P < 0.05).4.The results of ROC curve showed that the area under SIP,SDF,VEGF-C and NT-proBNP were all between 0.5 and 1.0,suggesting that SIP had better diagnostic value,among which SIP had the best diagnostic value for HF.The area under the cue curve of the combined four biomarkers was larger than the single detection value.Conclusions:1.Lymphangiogenic factors such as SIP,SDF-1 and VEGF-C are involved in the process of heart failure,and their serum concentration may be related to the degree of cardiac compensation.2.SIP,SDF-1 and vascular endothelial growth factor-C may play a positive regulatory role in improving cardiac function.3.S1 P and HDL may have synergistic effects in reducing cardiovascular risk events.4.The combined detection of SIP,SDF-1,VEGF-C and NT-proBNP has good diagnostic value for heart failure. |
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