| ObjectiveTo analyze the value of NT-proBNP,H-FABP and OPG in the severity of cardiac function and in clinical diagnosis and prognosis of patients with different types of heart failure.MethodsNinety-eight patients with chronic heart failure were selected from June 2020 to October 2020 in the Department of Cardiology,East Hospital,Shandong Provincial Hospital affiliated to Shandong University.The general clinical data of patients were collected,and the levels of H-FABP and OPG in peripheral blood were detected by enzyme linked immunosorbent assay(ELISA).According to the left ventricular ejection fraction(LVEF),the patients were divided into HFrEF(N=39),HFmrEF(N=11)and HFpEF(N=48)groups.The general clinical data and the levels of H-FABP and OPG in the three groups of patients with chronic heart failure were compared to analyze and evaluate the correlation of H-FABP and OPG with different clinical types and the severity of chronic heart failure,as well as echocardiographic indexes.Evaluating the diagnostic value of single and combined detection of NT-proBNP,H-FABP and OPG in patients with HFrEF and HFpEF.All patients were followed up for 3-6 months after discharge.According to the outcome of endpoint events(cardiovascular death or re-admission of heart failure)after half a year of follow-up,the predictive value of NT-proBNP,H-FABP and OPG in clinical prognosis of patients with chronic heart failure was evaluated-Results1.NT-proBNP,H-FABP and OPG were significantly different among the three groups of chronic heart failure(HFrEF,HFmrEF and HFpEF)(P<0.05);2.H-FABP was positively correlated with NYHA grade(r=0.61),LA(r=0.46),LV(r=0.51),HS-TnT(r=0.31),NT-proBNP(r=0.58)and SUA(r=0.38),and negatively correlated with LVEF(r=-0.76).OPG was positively correlated with NYHA grade(r=0.60),LA(r=0.36),LV(r=0.32)and NT-proBNP(r=0.49),and negatively correlated with LVEF(r=-0.60),(P<0.05);3.Multivariate regression analysis of NYHA grade of chronic heart failure showed that compared with NYHA Ⅱ,patients with elevated H-FABP had a 2.13-fold increased risk of developing NYHA Ⅲ(OR=2.13(1.099,4.112,P<0.05),and a 2.95-fold increased risk of developing NYHA Ⅳ(OR=2.95(1.429,6.072),P<0.05).However,there was no significant difference between OPG and NT-proBNP levels on the risk of NYHA Ⅱ,NYHA Ⅲ and NYHA Ⅳ in patients with chronic heart failure(P>0.05).4.Multivariate regression analysis of different groups of CHF showed that H-FABP was an independent risk factor for HFrEF and HFmrEF while the HFpEF as a controller.In patients with chronic heart failure,the higher the level of H-FABP in peripheral blood,the higher the risk of HFrEF(OR=2.37(1.596,3.529),P<0.001)and HFmrEF(OR=1.47(1.055,2.040),P<0.05).However,there was no significant difference between OPG and NT-proBNP levels in HFrEF,HFmrEF and HFpEF(P>0.05).5.Binary Logistic regression analysis of NT-proBNP,H-FABP and OPG showed that NT-proBNP had significant value in predicting the prognosis of patients with chronic heart failure,and the readmission rate and mortality of patients with chronic heart failure increased with the increase of NT-proBNP concentration(P<0.05).However,H-FABP and OPG had no significant effect on the prognosis of patients with chronic heart failure(P>0.05).6.Serum NT-proBNP,H-FABP and OPG have high diagnostic value for HFrEF.Compared with NT-proBNP,H-FABP had a higher sensitivity(94.9%)and specificity(83.1%)in the diagnosis of HFrEF,while OPG had a higher sensitivity(92.3%)and a poorer specificity(57.7%)in the diagnosis of HFrEF.Combined detection of NT-proBNP,H-FABP and OPG can improve the sensitivity(86.44%)and specificity(89.74%)in the diagnosis of HFrEF.7.Serum NT-proBNP,H-FABP and OPG have high diagnostic value for HFpEF.Compared with NT-proBNP,H-FABP had higher sensitivity(91.7%)and specificity(82.0)in the diagnosis of HFpEF,while OPG had higher specificity(82.0%)and poor sensitivity(58.3%)in the diagnosis of HFpEF.The combined detection of NT-proBNP,H-FABP and OPG can improve the sensitivity(91.7%)and specificity(78.0%)in the diagnosis of HFpEF,and H-FABP can be used as an important biomarker for early evaluation of cardiac dysfunction in patients with chronic heart failure.Conclusions1.Serum H-FABP and OPG are negatively correlated with LVEF in patients with chronic heart failure,and positively correlated with NYHA grade,which could reflect the severity of cardiac dysfunction.2.As a new biomarker,H-FABP has a certain value in the diagnosis of different clinical types of patients with CHF,and is an independent predictor of HFpEF and HFrEF in patients with chronic heart failure.3.NT-proBNP is an independent risk factor for end point events in patients with chronic heart failure,and can be used as an important biomarker for prognosis evaluation in patients with chronic heart failure.H-FABP and OPG had no significant prognostic value in patients with chronic heart failure.The detection of H-FABP and OPG can improve the sensitivity and specificity for the diagnosis of HFrEF and HFpEF,and the combined detection of H-FABP,OPG and NT-proBNP can be used as important biomarkers for early evaluation of cardiac dysfunction in patients with chronic heart failure.4.Detection of H-FABP and OPG can improve the sensitivity and specificity of the diagnosis for HFrEF and HFpEF.Combined detection of H-FABP,OPG and NT-proBNP can be used as an important strategy for early evaluation of cardiac function decline in patients with chronic heart failure. |
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