Relationship between serum NO,TXB2,ET-1 levels and NYHA cardiac function grading,cardiac function indicators in patients with chronic heart failure and their predictive value for prognosis
Objective To analyze the relationship between levels of serum nitric oxide(NO),thromboxane B2(TXB2)and endothelin-1(ET-1)and the New York Heart Association(NYHA)cardiac function grading,cardiac function indicators in patients with chronic heart failure(CHF)and their predictive value for progno-sis.Methods A total of 108 patients with CHF admitted to this hospital from August 2020 to August 2022 were selected as the study objects and divided into NYHA Class Ⅱ group,NYHA Class Ⅲ group and NYHA Class Ⅳ group according to the NYHA cardiac function grading criteria.During 1-year follow-up,patients were divided into poor prognosis group and good prognosis group according to whether serious arrhythmia,myocardial infarction,death and other adverse events occurred during the follow-up period.Pearson correlation was used to analyze the correlation between levels of serum NO,TXB2,ET-1 and cardiac function indexes in CHF patients with poor prognosis.Spearman correlation was used to analyze the correlation between levels of serum NO,TXB2,ET-1 and NYHA cardiac function grading in CHF patients.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in CHF patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum NO,TXB2 and ET-1 alone and in combina-tion for poor prognosis in patients with CHF.Results There were 28,41 and 39 patients in NYHA Class Ⅱ,Ⅲ and Ⅳ groups respectively.The serum NO level of CHF patients in NYHA Class Ⅳ group was lower than that in NYHA Class Ⅱ group and NYHA Class m group,the serum TXB2 and ET-1 levels in NYHA ClassⅣ group were higher than those in NYHA Class Ⅱ group and NYHA Class Ⅲ group,and the serum NO level in NYHA Class Ⅲ group was lower than that in NYHA Class Ⅱ group,and serum TXB2 and ET-1 levels in NYHA Class Ⅲ group were higher than those in NYHA Class Ⅱ group,and the differences were statistically significant(P＜0.05).During the follow-up period,14 cases of severe arrhythmia,18 cases of myocardial in-farction,and 7 cases of death occurred.There were 39 patients in the poor prognosis group and 69 patients in the good prognosis group.The levels of left ventricular end-diastolic diameter(LVEDD)and serum TXB2 and ET-1 in the poor prognosis group were higher than those in the good prognosis group,and the levels of left ventricular ejection fraction(LVEF)and serum NO in the poor prognosis group were lower than those in the good prognosis group,with statistical significance(P＜0.05).Spearman correlation analysis showed that ser-um NO level was negatively correlated with NYHA cardiac function grading in CHF patients(P＜0.05),and serum TXB2 and ET-1 levels were positively correlated with NYHA cardiac function grading(P＜0.05).Pearson correlation analysis showed that LVEF was positively correlated with serum NO level in CHF pa-tients with poor prognosis(P＜0.05),and negatively correlated with serum TXB2 and ET-1 levels(P＜0.05).There was a negative correlation between LVEDD and serum NO level,and a positive correlation be-tween LVEDD and serum TXB2 and ET-1 level in CHF patients with poor prognosis(P＜0.05).Multivariate Logistic regression analysis showed that NO＞51.02 μmol/L was a protective factor for poor prognosis in CHF patients(P＜0.05),and TXB2＞130.94 ng/L and ET-1＞57.43 ng/L were risk factors for poor prog-nosis in CHF patients(P＜0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum NO,TXB2 and ET-1 alone and combined with the 3 indexes to predict the poor prognosis of CHF pa-tients were 0.858,0.841,0.816 and 0.963 respectively.The AUC predicted by the combination of the 3 indexes was higher than that predicted by NO,TXB2,ET-1 alone(Z=2.579,2.638,3.312;P＜0.05).Conclusion Serum levels of NO,TXB2 and ET-1 are related to NYHA cardiac function grading and cardiac function index in CHF patients and can effectively predict the poor prognosis of patients.
chronic heart failurenitric oxidethromboxane B2endothelin-1cardiac function gradingprognosis
万方数据
维普
