Diagnostic value of cardiac ultrasound combined with miR-29b for coronary heart disease complicated by left ventricular hypertrophy
Objective To explore the diagnostic value of cardiac ultrasound combined with mi-croRNA(miR)-29b for coronary heart disease(CHD)complicated by left ventricular hypertro-phy(LVH).Methods A total of 68 patients with CHD and LVH admitted to the hospital from September 2018 to November 2023 were selected as the LVH group.Additionally,136 patients with CHD(without LVH)were selected as the non-LVH group.Both groups underwent cardiac ultrasound to measure relevant indices including left ventricular posterior wall thickness,inter-ventricular septal thickness,left ventricular end-diastolic diameter,and peak early diastolic filling velocity/peak late diastolic filling velocity(E/A ratio).Serum miR-29b expression was also measured.The correlation between serum miR-29b and cardiac ultrasound indices in pa-tients with CHD and LVH was analyzed.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of cardiac ultrasound indices and serum miR-29b for CHD with LVH.A regression predictive model for diagnosing CHD with LVH using these mark-ers was constructed and its predictive performance was analyzed.Results The LVH group had higher left ventricular posterior wall thickness,interventricular septal thickness,left ventricular end-diastolic diameter,and serum miR-29b levels compared with the non-LVH group,while the E/A ratio was lower(P<0.05).Pearson correlation analysis showed that serum miR-29b in CHD with LVH was positively correlated with left ventricular posterior wall thickness,inter-ventricular septal thickness,and left ventricular end-diastolic diameter,and negatively correla-ted with the E/A ratio(r=0.574,0.609,0.506,-0.628,respectively;all P<0.05).ROC curve analysis showed that both cardiac ultrasound indices and serum miR-29b were effi-cacious for diagnosing CHD with LVH.The Logistic binary regression model for combined diag-nosis yielded a predictive probability logit(P)=-29.027+9.964×left ventricular posterior wall thickness(cm)+2.729×interventricular septal thickness(cm)+0.286×left ventricular end-diastolic diameter(mm)-7.958×E/A+2.716×serum miR-29b.The Hosmer-Leme-show test showed good model fit(χ2=1.730,P=0.988).The ROC curve showed that the combined use of cardiac ultrasound indices and serum miR-29b had an AUC of 0.993 for diag-nosing CHD with LVH,significantly higher than any single index.The combined diagnostic sensitivity was 95.59%,and the specificity was 96.32%.Conclusion The combination of cardiac ultrasound with miR-29b improves the diagnostic value for CHD with LVH,providing a reliable basis for determining LVH.
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