Changes And Clinical Significance Of Serum Nneuregulin4 In Patients With Chronic Heart Failure

Objective: The aim of this study was to investigate the changes of serum NRG4 level in patients with chronic heart failure and its clinical significance in the diagnosis and severity evaluation of heart failure.Methods: We select 89 patients with chronic heart failure in the Second Hospital of Hebei Medical University from January 2020 to December 2020.According to the level of LVEF,the patients were divided into HFpEF group(LVEF≥50%),HFmrEF group(40%≤LVEF<50%)and HFrEF group(LVEF<40%).In the same period,we also select 30 healthy outpatients as the control group.The general clinical data and biochemical indexes of the subjects were collected and the serum levels of NRG4 were detected using ELISA.The data were analyzed with statistical software of SPSS 25.0.Result:1.Comparison of basic information in CHF groups: there was no significant difference in sex,age,history of hypertension,history of diabetes,total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and triglyceride(TG)in among the HFpEF group,HFmrEF group and HFrEF group(all P > 0.05).2.Comparison of Cardiac ultrasound index: compared with the control group,the serum level of LVEF、LVDD in the HFpEF group,HFmrEF group and the HFrEF group were statistically different(66.16±5.24,30.63±4.87,45.34±2.24,58.42±6.36;46.05±2.73,66.36±12.06,55.21±5.13,49.73±5.73).The LVDD in CHF group was higher than that in CON group,and the LVDD in HFrEF group was higher than that in HFmrEF group.3.The serum level of BNP in each group: compared with the control group,the serum level of BNP in the HFpEF group,HFmrEF group and the HFrEF group were all increased(33.15±6.45,1551.59±79.15,567.19±63.83,179.27±25.21)the difference was statistically significant.The serum level of BNP increased gradually with the decreased LVEF% among the HFpEF group,HFmrEF group and the HFrEF group,the difference was statistically significant(P<0.05).4.The serum level of NRG4 in each group: compared with the control group,the serum level of NRG4 in the HFpEF group,HFmrEF group and the HFrEF group were all decreased(109.52±5.78,56.58±1.25,65.94±4.00,87.65±5.32),the difference was statistically significant(P<0.05).5.Correlation analysis of nrg4 level and other clinical indicators:Spearman correlation analysis showed that NRG4 level was negatively correlated with BNP level and LVEDD(r=-0.853,-0.569,all P<0.01),and was positively correlated with LVEF(r= 0.869,P<0.01).6.The serum level of NRG4 in different cause of the disease: there were no statistical difference among the IHD HF group,DCM HF group and HHD HF group(70.46 ± 13.96pg/ml,68.74 ± 12.52pg/ml,68.82 ±15.43pg/ml)。7.Binary logistic regression showed that Nrg4 is an independent factor of CHF.Conclusion: CHF is a complex clinical syndrome caused by multiple factors.NRG4,as a new biomarker,may be involved in the development of CHF.It has important clinical reference value in CHF diagnosis,guiding heart function classification and severity assessment,and is a biomarker of research value.