| Objective:To investigate the relationship between apolipoprotein E (ApoE) gene,NT-ProBNP,homocysteine and left ventricular hypertrophy in patients with coronary heart disease.Methods:From March 2017 to August 2018,236 patients were admitted to the First Affiliated Hospital of Nanchang University and diagnosed with coronary heart disease by coronary angiography,including 142 males,accounting for 60.2%,and 94females,accounting for 39.8%.All patients enrolled included previous hypertension,hyperlipidemia,severe liver and kidney dysfunction,and severe cardiac insufficiency.Left ventricular end-diastolic diameter (LVEDD) ,interventricular septal thickness (IVST) ,left ventricular posterior wall thickness (LVPWT) were measured by cardiac color Doppler ultrasound,and left ventricular mass index (LVMI) was calculated according to standard formula and based on left ventricular mass.The index was divided into left ventricular hypertrophy group (80 cases) and left ventricular normal group (156 cases) .At the same time,the patient's age,gender,body mass index (BMI) ,diabetes history,smoking history,systolic blood pressure,diastolic blood pressure,total cholesterol (TC) ,triglyceride (TG) ,high-density lipoprotein cholesterol (HDL-C) ,and low were collected.Clinical data such as density lipoprotein cholesterol (LDL-C) ,NT-ProBNP,homocysteine,ApoE genotype.All enrolled patients were the first to undergo coronary angiography and diagnosed as coronary heart disease according to relevant criteria.ApoE genotypes and?2,?3,?4 allele frequencies were compared in 236 patients with coronary heart disease,and the correlation between ApoE gene,NT-ProBNP,homocysteine and left ventricular mass index was analyzed.And further analysis of the correlation between ApoE gene,NT-ProBNP,homocysteine and left ventricular hypertrophy.Results:1.Six genotypes (ApoE2/2,ApoE2/3,ApoE2/4,ApoE3/3,ApoE3/4,ApoE4/4) and three alleles (?2,?3,?4) were found in 236 patients with CHD.The most common genotype was ApoE3/3 (53.4%) ,followed by ApoE3/4 (22%) .The most common allele was?3 (69.9%) ,followed by?4 (20.3%) .2.The plasma TC level (5.06±0.56mmol/L) was significantly higher (P<0.05) and LDL-C level (3.38±0.41mmol/L) was significantly higher in ApoE4 carriers than in ApoE3/3 genotype.The difference was statistically significant (P<0.05) .There were no significant differences in TC,TG,HDL-C,LDL-C,NT-ProBNP,and Hcy between ApoE2 carriers and ApoE3/3.3.The incidence of left ventricular hypertrophy (LVH) and left ventricular mass index[(112.4±13.75) g/m~2 VS (93.2±10.68) g/m~2]were significantly higher in ApoE4 carriers than in ApoE3/3 genotype.The difference was statistically significant (P<0.05) .There was no significant difference in the incidence of left ventricular hypertrophy and left ventricular mass index between ApoE2 carriers and ApoE3/3genotypes (P>0.05) .4.Age of disease in LVH group[(63.9±6.7) age VS (58.1±5.2) age],systolic blood pressure[(135.9±17.4) mmHg VS (124.3±15.6) mmHg],plasma NT-ProBNP level[(876.48±286.25) ng/L VS (654.34±137.46) ng/L],plasma Hcy level[(14.53±5.61) ?mol/L VS (11.71±4.38) ?mol/L]?LVEDD (45.1±5.37cm) ?IVST (11.2±3.29cm) ?LVPWT (10.5±2.94cm) ?LVMI[(113.9±10.34) g/m~2 VS (93.2±11.61) g/m~2]were higher than non-LVH group,the difference was statistically significant (P<0.05) .There were no significant differences in gender,body mass index,smoking history,diabetes prevalence,diastolic blood pressure,TC,TG,LDL-C,HDL-C between the two groups (all P>0.05) .5.According to age,gender,body mass index,smoking history,diabetes history,systolic blood pressure,diastolic blood pressure,TC,TG,LDL-C,HDL-C,NT-ProBNP,Hcy,ApoE genes as independent variables,LVMI was a single factor correlation analysis of the dependent variables.The results showed that LVMI was positively correlated with age,systolic blood pressure,NT-ProBNP,Hcy,E4 gene carrying (P<0.05) ,There were no significant correlations between LVMI and gender,body mass index,smoking history,diabetes,diastolic blood pressure,TC,TG,LDL-C and HDL-C (P>0.05) .6.Multivariate logistic regression analysis was performed with the presence or absence of LVH as the dependent variable.It was found that NT-ProBNP (OR value1.603,95%CI:1.197-3.910) ,Hcy (OR value 2.735,95%CI:1.140-5.736) is risk factors of LVH.Conclusion:1.The most common genotype in patients with coronary heart disease is ApoE3/3,followed by ApoE3/4.The most common allele is?3,followed by?4.2.ApoE gene polymorphism has an effect on blood lipid levels.Compared with other genotypes,patients with coronary heart disease carrying the ApoE 4 gene may have higher plasma TC and LDL-C levels.3.ApoE gene polymorphism is associated with left ventricular mass index (LVMI) .Patients with coronary heart disease carrying ApoE 4 gene may be more likely to develop LVH,but ApoE gene polymorphism is not an independent risk factor for LVH.4.Plasma NT-ProBNP and Hcy may be risk factors for LVH in patients with coronary heart disease.Patients with coronary heart disease with elevated plasma levels of NT-ProBNP and Hcy may be more likely to develop LVH. |
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