| Objective:To investigate the clinical significance of insulin-like growth factor binding protein-7(IGFBP-7)in patients with heart failure(HF),we measured the concentration in serum of IGFBP-7 in patients with HF.We analyzed the relationship between IGFBP-7 level and left ventricular ejection fraction(LVEF),New York Cardiac Function grade,different basic cardiovascular diseases and related parameters of Echocardiography.Methods: A total of 180 HF patients(HF group)who were hospitalized in the Department of Cardiology,Changsha Central Hospital,Affiliated to the University of South China from April to July 2020 were collected consecutively,and 60 healthy people(control group)who were admitted to the Health Management Center of Changsha Central Hospital,Affiliated to the University of South China during the same period for physical examination without underlying cardiovascular diseases were collected(control group).According to LVEF,HF group was divided into three subgroups: HFr EF group,HFmr EF group and HFp EF group.General data,New York cardiac function classification,basic disease status,relevant laboratory examinations,cardiac color ultrasound(including LVEF,left atrial diameter,left ventricular end-diastolic diameter,interventricular septal thickness,E peak /A peak)and other relevant observation indexes of the subjects were collected,and fasting elbow venous blood was collected in the morning,the serum concentration of IGFBP-7 was determined by enzyme-linked immunosorbent assay(ELISA).The concentration differences of IGFBP-7among HF patients with different LVEF,different New York Cardiac Function grade and different basic cardiovascular diseases were compared,and the correlation analysis between IGFBP-7 and various parameters of Echocardiography was conducted.Through the confounding bias of propensity score matching(PSM)comparison between control groups,the differences concentration in serum of IGFBP-7 between different HF patients were compared by using obtained after PSM.This study has been approved by the Institutional Review Board,and all participants have given informed consent.Results:1.Comparison of general information between HF group and control group: the age of HF group was higher than that of control group(P<0.05),and there were no statistical differences in gender,BMI,systolic blood pressure,diastolic blood pressure and heart rate between the two groups.The levels of glutamic-oxalacetic transaminase,creatinine,urea nitrogen and uric acid in HF group were higher than those in control group(all P<0.05),and the levels of platelet,triglyceride,total cholesterol and low density lipoprotein cholesterol in HF group were lower than those in control group(all P<0.05).There were no significant differences in the levels of high density lipoprotein cholesterol,white blood cells,hemoglobin,fasting blood glucose and alanine aminotransferase between the two groups(all P>0.05).2.Comparison of serum IGFBP-7 concentration between HF group and control group:(1)The serum concentrations of IGFBP-7 in HF group and control group were 48.34(25.42,74.71)ng/m L and 16.13(11.64,24.87)ng/m L,respectively,the difference was statistically significant(P< 0.05).(2)By using PSM to control the confounding bias,there was no statistical difference in all general data between the HF group and the control group,and a total of 28 pairs were successfully matched.After PSM matching,the serum concentrations of IGFBP-7 in the HF group and the control group were 46.85(29.44,69.48)ng/m L and 15.38(10.29,respectively).24.40 ng/m L,the difference was still statistically significant(P<0.001),suggesting that the serum IGFBP-7 concentration in HF group was significantly higher than that in control group.3.Comparison of serum IGFBP-7 concentration in three groups of HF patients:(1)The levels of serum IGFBP-7 in HFr EF group,HFmr EF group and HFp EF group were 48.34(18.74,72.69)ng/m L,59.55(35.48,121.00)ng/m L and 33.90(21.56,49.83)ng/m L,respectively.There was no significant difference in concentration of serum IGFBP-7 among the three groups of HF patients(P>0.05).(2)After PSM,there was no significant difference in concentration of serum IGFBP-7 in HF patients among the three groups(P>0.05).4.Comparison of serum IGFBP-7 concentration among HF patients with different New York cardiac function grades:(1)The serum concentrations of IGFBP-7 in patients with the New York Heart Function grade Ⅱ,Ⅲ and Ⅳ were 30.75(20.15,46.89)ng/m L,49.96(25.46,74.71)ng/m L,and 71.69(46.27,103.26)ng/m L,respectively.The serum concentration of IGFBP-7 in patients with the New York Heart Function grade Ⅳ was significantly higher than that in patients with grade Ⅱ and grade Ⅲ(P<0.05),and the concentration of IGFBP-7 gradually increased with the increase of New York Heart Function grade(P for trend<0.001).(2)After PSM,the serum concentration of IGFBP-7 in patients with the New York Heart Function grade Ⅳ was still significantly higher than that in the patients with the New York Heart Function gradeⅡ(P<0.05).5.Comparison of serum IGFBP-7 concentration in HF patients with different basic cardiovascular diseases:(1)There was no difference in serum IGFBP-7 concentrations among patients with or without hypertension,coronary heart disease and valvular heart disease;However,the concentration of serum IGFBP-7 in HF patients with myocardial disease was significantly higher than that in HF patients without myocardial disease,which was 70.44(45.36,100.52)ng/m L and 40.32(24.74,68.25)ng/m L,respectively,with statistical significance(P<0.05).(2)After PSM,the serum IGFBP-7 concentration in HF patients with myocardial disease was still significantly higher than that in HF patients without myocardial disease(P<0.05).6.Correlation between serum IGFBP-7 concentration and related parameters of Echocardiography in HF patients: IGFBP-7 was positively correlated with left atrial diameter and left ventricular end-diastolic diameter(r= 0.219 and 0.199,both P<0.05),and negatively correlated with E peak /A peak(r=-0.205,P<0.05).Conclusion:1.Among patients with heart failure,serum IGFBP-7 concentrations were significantly elevated and were associated with the severity of heart failure symptoms.2.Serum IGFBP-7 concentrations in patients with heart failure maybe were associated with cardiac structural changes and dysdiastolic function. |
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