| Objectives : To investigate the changes and clinical significance of serum Low Density Lipoprotein Cholesterol(LDL-C)and Soluble Growth Stimulating Expressed Gene 2 Protein(s ST2)in patients with heart failure in different ejection fraction groups.Provide a reference for clinical assessment of the severity of heart failure.Methods:A total of 238 patients with heart failure(HF)who were admitted to the Department of Cardiology in our hospital from September 2019 to December 2021 were selected.Coronary arteriography(CAG)confirmed no coronary stenosis in our hospital、N-terminal pro-Brain natriuretic peptide(NT-pro BNP)value and no abnormality in various laboratory examinations were 68 cases in the control group.The general information of the patients on admission was collected and recorded,fasting venous blood was collected,and the LDL-C values of the two groups of patients were detected.In addition,3-5ml venous blood samples were collected from patients to detect the levels of s ST2 and NT-pro BNP.All patients completed echocardiography,collected left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF),and according to the LVEF results of echocardiography after admission,According to the latest European Society of Cardiology criteria in 2021,HF patients were divided into heart failure with preserved ejection fraction(HFp EF,n=95),heart failure with mildly reduced ejection fraction(HFmr EF,n=60)and heart failure with reduced ejection fraction(HFr EF,n=83),The changes and clinical significance of s ST2 and LDL-C in each group were compared and analyzed.Results:1.Compared with the normal control group,the age,gender,heart rate,smoking history,atrial fibrillation history,diabetes history,LVEDD,LVEF,s ST2 and NT-pro BNP values in the HF group were significantly different(P<0.05).;LDL-C was not statistically different.2.The age,gender,history of atrial fibrillation,LVEDD,LVEF,LDL-C,sST2 and NT-pro BNP values of the three groups of patients with different ejection fractions in the HF group were all significant differences(P<0.05).The values of LVEDD,LDL-C,s ST2 and NT-pro BNP gradually increased as the ejection fraction decreased;there were no significant differences in heart rate,hypertension history,systolic blood pressure,diastolic blood pressure,smoking history,coronary heart disease history and diabetes history among the three groups(P >0.05).3.The results of correlation analysis showed that: in HFpEF group,sST2 was positively correlated with NT-pro BNP level(r=0.656,P<0.001),LDL-C was positively correlated with systolic blood pressure(r=0.237,P=0.023),and there was no correlation between s ST2 and LDL-C.In the HFmr EF group,there was a positive correlation between s ST2 and NT-pro BNP levels(r=0.659,P<0.001)and no correlation with LDL-C.In the HFr EF group,there was a positive correlation between s ST2 and NT-pro BNP levels(r=0.473,P=<0.001)and no correlation with LDL-C.4.The ROC curve analysis showed that the area under the ROC curve of sST2 in the diagnosis of HF was 0.915(P<0.05),the optimal critical value was 23.71ng/ml,the sensitivity was 76.5%,and the specificity was 95.6%.LDL-C has no significance in the diagnosis of HF(P>0.05).5.Coronary heart disease,NT-proBNP and sST2 are risk factors for HF.One unit increase in coronary heart disease was associated with a 36.3% increased risk of heart failure;one unit increase in NT-pro BNP was associated with a 1.3% increased risk of heart failure;and one unit increase in s ST2 was associated with an 18.3% increased risk of heart failure.Conclusions:1.With the decrease of ejection fraction in HF patients,serum s ST2 and LDL-C values increased sequentially,which has important clinical significance for predicting the severity of heart failure.2.s ST2 is an independent risk factor for HF and can improve the accuracy of HF diagnosis. |
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