Expression And Diagnostic Value Of Insulin-like Growth Factor Binding Protein-7 In Heart Failure

Objective The aim of this study was to investigate the expression of insulin-like growth factor binding protein-7(IGFBP-7)combined with N-terminal B-type natriuretic peptide(NT-pro BNP)in patients with different types of heart failure(HF)。At the same time,the relationship between IGFBP-7and cardiac structure and risk stratification was observed,and the application value of IGFBP-7 in the diagnosis of HF was evaluated.Methods A total of100 patients with HF and 30 patients with normal or slightly abnormal diastolic function but no clinical symptoms were collected from the inpatient and emergency department of the affiliated Hospital of Medical College of Inner Mongolia University from November 2019 to December 2020 as the control group.According to the left ventricular ejection fraction((LVEF)),the patients were divided into three groups: 30 patients with reduced ejection fraction((HFr EF))with LVEF < 40%,27 patients with heart failure with median ejection fraction((HFmr EF))with 40% ≤ LVEF < 50%,and 43 patients with(HFp EF)with LVEF ≥ 50%.At the same time,the HFp EF group was divided into II grad,III grade and IV grade according to New York Heart Association(NYHA)cardiac function grade.Detection of serum IGFBP-7 concentration by enzyme linked immunosorbent assay(ELISA)in all subjects.The concentration of serum NT-pro BNP was detected by automatic chemiluminescence method.The concentrations of serum NT-pro BNP and IGFBP-7 in HFr EF group,HFmr EF group,HFp EF group and control group were compared.The concentrations of serum NT-pro BNP and IGFBP-7 in different NYHA cardiac function grades in HFp EF group were compared.The cardiac function and structure of the patients were evaluated by echocardiography.The data were analyzed by SPSS20.0.Results The level of serum IGFBP-7 in HF group was significantly higher than that in normal group(P<0.001).The level of NT-pro BNP in HF group was significantly higher than that in normal group(The median is 3647.00 、 78.00,P<0.001).The serum level of IGFBP-7 in HFp EF group was significantly higher than that in HFr EF group(P < 0.001).There was significant difference in IGFBP-7 serum level between HFr EF group and HFmr EF group(P > 0.001).There was a significant difference in IGFBP-7serum level between HFp EF group and HFmr EF group.In the control group,HFr EF group,HFp EF group and HFmr EF group,the receiver operating characteristic(ROC)area under curve(AUC)of IGFBP-7 and NT-pro BNP in the diagnosis of HFREF,HFmr EF and HFp EF respectively.0.781(P<0.001)、0.510(P=0.859),the AUC of IGFBP-7 combined with NT-pro BNP for HFREF,HFmr EF and HFp EF under ROC was 0.859(P<0.001).In HFr EF group,serum IGFBP-7 increased with the increase of NYHA cardiac function grade,and there was significant difference among different NYHA grades(P<0.05 of all).Correlation analysis showed that serum IGFBP-7 was correlated with LVEF,left atrial diameter(LAD),mitral inflow peak early filling velocity(E),mitral inflow peak later diastolic filling velocity(A)and Emax A ratio(P<0.05 of all).Conclusion In patients with HF,we found that the concentration of IGFBP-7is closely related to a wide range of cardiac diastolic dysfunction.The increase of serum concentration of IGFBP-7 indicates that the diastolic function deteriorates seriously.Serum IGFBP-7 has high diagnostic value for HFp EF.In patients with HFp EF,the concentration of IGFBP-7 increases with the increase of NYHA grade,so it is used as a biomarker for the diagnosis and risk stratification of HFp EF.