Correlation between serum Fibulin-3,TEM1,PACAP-38 levels and cardiac function grading and poor prognosis in elderly patients with chronic heart failure
Objective To analyze the correlation between serum Fibulin-3,anti-human tumor endothelial marker 1(TEM1),pituitary adenylate cyclase activating polypeptide-38(PACAP-38)levels and cardiac func-tion grading and poor prognosis in elderly patients with chronic heart failure(CHF).Methods A total of 132 elderly CHF patients admitted to this hospital from July 2020 to July 2023 were selected as the elderly CHF group,and 132 healthy subjects who underwent physical examination in this hospital during the same period were selected as the control group.According to the New York Heart Association(NYHA)cardiac function grading criteria,the elderly patients with CHF were divided into grade Ⅱ group(42 cases),grade Ⅲ group(51 cases)and grade Ⅳ group(39 cases).According to the occurrence of MACE after discharge,elderly CHF patients were divided into MACE group and non-MACE group.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of serum Fibulin-3,TEM1 and PACAP-38.Spearman correlation anal-ysis was used to analyze the correlation between serum Fibulin-3,TEM1,PACAP-38 levels and cardiac func-tion classification in elderly patients with CHF.Multivariate Logistic regression was used to analyze the influ-encing factors of MACE in elderly patients with CHF.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Fibulin-3,TEM1 and PACAP-38 for MACE in elderly CHF pa-tients.Results Serum TEM1 level of elderly CHF group was higher than that of control group,and serum Fibulin-3 and PACAP-38 levels of elderly CHF group were lower than those of control group,and the differ-ences were statistically significant(P＜0.05).The serum TEM1 level of elderly CHF patients with different cardiac function grades was compared in grade Ⅱ group＜grade Ⅲ group＜grade Ⅳ group,and the difference between any two groups was statistically significant(P＜0.05).Comparison of serum Fibulin-3 and PACAP-38 levels in elderly CHF patients with different cardiac function grades,grade Ⅱ group＞grade Ⅲ group＞grade Ⅳ group,and the difference between any two groups was statistically significant(P＜0.05).Spearman correlation analysis showed that the cardiac function grading of elderly CHF patients was positively correlated with serum TEM1 level(rs=0.488,P＜0.05),and negatively correlated with the expression levels of Fibu-lin-3 and PACAP-38(rs=-0.463 and-0.432,P＜0.05).There were 38 patients in the MACE group and 94 patients in the non-MACE group.The levels of serum Fibulin-3 and PACAP-38 in MACE group were lower than those in non-MACE group,and serum TEM1 level and the proportion of patients with heart function grade Ⅳ in MACE group were higher than those in non-MACE group,with statistical significance(P＜0.05).Multivariate Logistic regression analysis showed that increased serum Fibulin-3 and PACAP-38 levels were protective factors for MACE in elderly CHF patients(P＜0.05),and increased serum TEM1 level and heart function grade Ⅳ were risk factors for MACE in elderly CHF patients(P＜0.05).ROC curve analysis showed that the area under the curves(AUCs)of serum Fibulin-3,TEM1 and PACAP-38 alone and combined with the 3 indexes to predict MACE in CHF patients were 0.666,0.636,0.641 and 0.798 respectively.The AUC predicted by combination of 3 indexes was higher than that predicted by serum Fibulin-3,TEM1 and PACAP-38 alone respectively(Z 3 combination-Fibulin-3=2.448,P=0.014;Z 3 combination-TEM1=2.033,P=0.042;Z3 combination-PACAP-38=2.200,P=0.028).Conclusion The evels of serum Fibulin-3 and PACAP-38 in elderly CHF patients are obviously reduced,while the expression level of TEM1 is obviously increased,which are closely related to cardiac function grading and prognosis.The combined value of the three indexes is higher in predicting the occurrence of MACE in elderly CHF patients.
维普
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