| Objective To observe the changes of serum galectin-3(GAL-3)and growth differentiation factor 15(GDF-15)in patients with heart failure with preserved ejection fraction(HFpEF),and to explore the diagnostic value of GAL-3 and GDF-15 for HFpEF and its correlation with cardiac function grading.Methods According to the diagnostic criteria for HFpEF in Chinese Heart Failure Diagnosis and Treatment Guide 2018,60 patients with HFpEF who were admitted to the Department of Cardiovascular Diseases of the First Affiliated Hospital of Jiamusi University from October 2018 to October 2019 were included as HFpEF group according to New York Heart Function Classification(NYHA).16 patients with cardiac function II group,24 patients with cardiac function III group,20 patients with cardiac function class IV,at the same time,30 healthy people who underwent physical examination in our hospital were selected as the control group(Normal heart function group).The clinical data of the enrolled patients were collected,and the serum N-terminal pro-brain natriuretic peptide(NT-pro BNP),GAL-3,GDF-15 level and left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left atrial diameter(LAD)were compared in each group.Differences were used to analyze the correlation between the indicators and the correlation between GAL-3,GDF-15 and cardiac function grading,and to evaluate the value of GAL-3,GDF-15 in diagnosing HFpEF by receiver operating characteristic(ROC)curve.Results1.Compared with the normal heart function group,the serum NT-pro BNP,GAL-3,GDF-15 levels of patients in the HFpEF group were significantly increased(all p <0.01).Compared with the cardiac function class II group,the serum levels of NT-pro BNP,GAL-3,and GDF-15 in patients with cardiac function class III and cardiac function class IV were increased(all P <0.05),compared with the cardiac function class III group.The above indexes of cardiac function IV group were also at a high level(P <0.05).2.GAL-3 and GDF-15 were positively correlated(r = 0.66,p <0.05),and GAL-3,GDF-15 and NT-pro BNP levels were respectively positively correlated(r = 0.72,0.65,p <0.05).3.GAL-3 and GDF-15 are weakly negatively correlated with LVEF(r =-0.40,-0.35,p <0.05),have no correlation with LVEDD(r = 0.13,0.15,p> 0.05),and have no correlation with LAD Correlation(r = 0.16,0.21,p> 0.05).4.The area under the ROC curve of NT-pro BNP,GAL-3,and GDF-15 for diagnosing HFpEF are 0.882,0.838,and 0.809(all p <0.05).When the NT-pro BNP cut-off value is 566.5,the sensitivity is 83.3% The specificity is 91.7%.When the GAL-3 cutoff value is 85.04,the sensitivity is 80% and the specificity is 86.7%.When the GDF-15 cutoff value is 87.4,the sensitivity is 76.7% and the specificity is 83.3%.The area under the ROC curve for the combined diagnosis of HFpEF by both NT-pro BNP and GAL-3 is 0.917(p <0.05),the sensitivity is 86.7%,and the specificity is 93.3%.Both NT-pro BNP and GDF-15 are used to diagnose HFpEF.The area under the ROC curve was 0.912(p <0.05),the sensitivity was 93.3%,and the specificity was 85%.Conclusions1.Serum GAL-3 and GDF-15 are of great value in the diagnosis of HFpEF patients.2.Serum levels of GAL-3 and GDF-15 in patients with HFpEF increase with the degree of deterioration of cardiac function,which can be used as a biomarker to reflect the degree of cardiac function impairment.3.NT-pro BNP combined with GAL-3 test or NT-pro BNP combined with GDF-15 test can improve the accuracy of HFpEF diagnosis. |
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