Correlation Between Serum Neuregulin4 Level And Left Ventricular Remodeling In Patients With Acute Myocardial Infarction

Objective:The purpose of this study was to investigate the correlation between serum NRG4 level and left ventricular remodeling(LVR)in patients with acute myocardial infarction(AMI).Methods:Seventy patients with first diagnosed acute ST-segment elevation myocardial infarction(STEMI)were enrolled in the experimental group and successfully received thrombolysis or PCI within 24 hours of onset,while 22 healthy subjects were enrolled in the control group.Serum NRG4 levels were measured by ELISA within 48 hours after the onset of symptoms,and the NRG4 levels were compared between the experimental group and the control group.Echocardiography was performed within 48 hours of the onset of acute myocardial infarction in the experimental group and at 3 months follow-up.Left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)were recorded twice.The standard for left ventricular remodeling was LVEDV change rate ≥15%.According to this standard,the experimental group could be divided into left ventricular remodeling group and non-left ventricular remodeling group,and whether there was any difference in NRG4 level between the two groups was compared.The t-test was used to compare the two groups of mean,and the analysis of variance was used to compare the three groups of mean.Pearson linear correlation was used for correlation analysis.Logistic regression analysis was performed using age,gender,BMI,FPG,TC,LDL,TG,smoking,family history of cardiovascular disease,use of β-blockers and ACEI/ARB drugs,serum NRG4 level as the independent variable and left ventricular remodeling as the dependent variable.Results:1.the serum NRG4 level in control group(61.13±19.06 pg/ml)was higher than that in left ventricular remodeling group(16.57±8.18 pg/ml)and non-left ventricular remodeling group(31.33±9.93 pg/ml),while that in left ventricular remodeling group was lower than that in non-left ventricular remodeling group(P<0.05).2.The LVEDV(129.37±29.54ml)of the left ventricular remodeling group and the LVEDV(139.37±29.52ml)of the non-left ventricular remodeling group had no difference within 48 hours after onset.The LVEF(52.72±7.72%)of the left ventricular remodeling group and the LVEF(50.41±7.95%)of the non-left ventricular remodeling group had no difference within 48 hours after onset.At 3 months after the onset,the LVEDV(161.33±31.46ml)of the left ventricular remodeling group was higher than that of the non-left ventricular remodeling group(145.22±30.49ml),and the LVEF(44.00±7.26%)of the left ventricular remodeling group was lower than that of the non-left ventricular remodeling group(47.91±7.79%),P<0.05.3.In the left ventricular remodeling group,the serum NRG4 level was negatively correlated with the rate of change of LVEDV(r=-0.569,P<0.01),and positively correlated with the rate of change of LVEF value(r=0.693,P<0.01).Logistic regression analysis using age,BMI,FPG,TC,LDL,TG and serum NRG4 level as independent variables showed that only NRG4 level had an effect on left ventricular remodeling(OR=1.222,P<0.01).Conclusions:The serum NRG4 level of the experimental group was lower than that of the control group,and the serum NRG4 level of the left ventricular remodeling group was lower than that of the non-left ventricular remodeling group.NRG4 level was negatively correlated with the degree of left ventricular remodeling after AMI.Serum NRG4 level may be an important factor in predicting the degree of left ventricular remodeling after AMI.