Analysis Of Serum ACE,Ang?,ACE2,Ang(1-7) Levels In Patients With Heart Failure

Objective 1 Analyzing the changes of serum Ras components [ACE?Ang ??ACE2?Ang(1-7)] of the patients with heart failure.2 Findding whether there are differences in serum RAS components of heart failure patients(different cardiac function grades,NTpro BNP levels,ejection fraction,and atrial fibrillation).3 Investigating whether serum RAS components level can be used as an influencing factor for short-term MACE events of patients with heart failure after discharge.Methods Select the patients without heart failure(40 cases)who were treated in the Department of Cardiology in the Department of Cardiology of North China University of Technology from December 2018 to December 2019 as the control group,Select heart failure patients(145 cases)to be treated in the cardiology ward to be included in the experimental group.Follow-up observations during hospitalization to collect the general clinical data,biochemical indicators,and cardiac color Doppler ultrasound indicators of the selected candidates.Serum ACE,Ang ?,ACE2,Ang(1-7)levels were analyzed by enzyme-linked immunosorbent assay(ELISA).According to cardiac function classification,nt-probnp level,ejection fraction and whether combined with atrial fibrillation after stratification,determine whether there is a difference in the level of RAS components in patients with heart failure.Short-term Major Adverse Cardiovascular Events(MACE events)were recorded in patients with heart failure.SPSS19.0 software was used for statistical analysis,multi-factor logistic regression was used to explore whether serum RAS components levels could be used as influencing factors for short-term MACE events,and ROC curve test was used to assess prognostic ability.Results 1 There were 145 patients in experimental group,91 males(62.8%)and 54 females(37.2%)with an average age of 66.21�9.55 years.There were 40 patients in the control group,17 males(42.5%),23 females(57.5%)with an average age of 63.35�5.39 years.2 Compared with the control group,the experimental group had higher ACE levels(47.34�7.36 vs 52.22�8.50ng/L,P<0.05),and higher Ang ? levels(21.12�3.94 vs 23.29 � 4.19pg/ml,P<0.05),The ratio of ACE to ACE2(ACE/ACE2)is higher(2.48�0.54 vs 2.73�0.60,P<0.05),the ratio of Ang ? and Ang(1-7)[Ang ?/Ang(1-7)] is higher(0.26�0.05 vs 0.31�0.07,P<0.05).3 Compared with NYHA ???I group patients,NYHA IV group had higher levels of Ang ? and Ang ?/Ang(1-7)and were positively correlated with cardiac function grade(r values were 0.181,0.166,P<0.05),and Ang(1-7)level showed a downward trend(78.09�11.45 vs 74.33�9.29 ng / L,P<0.05).4 Compared with patients in the low NT-pro BNP group,the high NT-pro BNP group had higher levels of Ang ?,Ang ?/Ang(1-7)and had a positive correlation with NT-pro BNP level stratification(r values were 0.256,0.316,P<0.05),while Ang(1-7)level is low and negatively correlated with NT-pro BNP level stratification(r=-0.232,P<0.05).5 Compared with patients in the HFp EF group,the Ang ? level was higher in the HFr EF group(22.70�3.96 vs 24.59�4.42pg/ml,P<0.05),and the Ang ?/Ang(1-7)level was higher(0.29�0.06 vs 0.34�0.08,P<0.05),while the Ang(1-7)level was lower(77.92�11.07 vs 73.80�9.66ng/L,P<0.05);the RAS levels of HFp EF patients with different cardiac function grades were further compared,compared with the NYHA ???I group,the RAS level of HFp EF retention patients in the NYHA IV group was higher(21.98�3.55 vs 24.44�4.42p/ml,P<0.05),Ang ?/Ang(1-7)Higher level(0.28�0.06 vs 0.36�0.07,P<0.05)and lower Ang(1-7)level(79.17�11.71 vs 74.85�8.77ng/L,P<0.05).6 Compared with the heart failure SR group,the heart failure AF group had higher levels of Ang ?(22.75�3.95 vs 24.33�4.47pg/ml,P<0.05).7 Multivariate logistic regression analysis of short-term MACE events in patients with heart failure shows that Ang ?,high NT-pro BNP level,and low LVEF are independent risk factors for the occurrence of MACE events in patients with heart failure within 3 months after discharge [OR value(95%CI)were 1.286(1.145?1.444),7.000(2.709?18.089),5.362(2.095?13.721),P<0.05].The area under the ROC curve of Ang ? for predicting short-term MACE events is 0.793,the 95% confidence interval is 0.653?0.825,the cut-off value of the best diagnosis is 24.01pg/ml,the sensitivity is 70.3%,and the specificity is 70.2%.Conclusion 1 Serum ACE and Ang ? levels increase in patients with heart failure,and there is a relative increase in ACE/ACE2 and Ang ?/Ang(1-7).2 Increased serum Ang ? levels and decreased Ang(1-7)levels in patients with heart failure are associated with worsening cardiac function.3 Patients with heart failure and atrial fibrillation have higher levels of serum Ang ?.4 Serum Ang ? level,higher NT-pro BNP,and lower LVEF are risk factors for MACE events of patients with heart failure within 3 months after discharge from.Serum Ang ? level has predictive value for short-term MACE events.Figure1;Table14;Reference 205...