Predictive value of serum sST2,TGF-β1 and CTGF levels to the short-term adverse prognosis of patients with heart failure with preserved ejection fraction
Objective:To investigate the predictive value of serum soluble suppression of tumorigenicity 2(sST2),transforming growth factor-β1(TGF-β1)and connective tissue growth factor(CTGF)levels to the short-term adverse prognosis in patients with heart failure with preserved ejection fraction(HFpEF).Methods:The clin-ical data of 405 patients with HFpEF who were hospitalized in the Second People's Hospital of Changshu from May 2019 to May 2024 were retrospectively analyzed.A total of 400 patients who went to our hospital for physical ex-amination during the same period were selected as the control group.Based on the occurrence of major adverse cardiac events(MACEs)within 6-months follow-up period,the 405 HFpEF patients were divided into MACEs group(n=59)and no MACEs group(n=346)according to whether MACEs occurred during the 6 months of fol-low-up.Univariate analysis and Cox multivariate regression analysis were performed to evaluate the predictive val-ue of each index by plotting the receiver operating characteristic curve(ROC).Results:In the HFpEF group,the serum levels of sST2,TGF-β1,CTGF,IVST,and NT-proBNP were significantly higher than those in the control group,the difference was statistically significant(P＜0.05),and the left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and E/A were significantly lower than those in the control group,the difference was statistically significant(P＜0.05).Serum sST2,TGF-β1 and CTGF were positively correlated with IVST and NT-proBNP(P＜0.05)and negatively correlated with LVEF,LVEDD and E/A(P＜0.05).Univariate analysis showed that there were no significant differences in age,gender,complications and creatinine between MACEs group and no-MACEs group,the difference was statistically significant(P＞0.05).However,there were statistical differences in NYHA cardiac function classification,LVEF,LVEDD,E/A,IVST,NT-proBNP,sST2,TGF-β1 and CTGF between the two groups,the difference was statistically significant(P＜0.05).The re-sults of Cox multivariate survival analysis showed that LVEF,E/A,IVST,NT-proBNP,sST2,TGF-β1 and CT-GF were independent influencing factors for short-term adverse prognosis in patients with HFpEF(P＜0.05).The results of ROC showed that the AUC and specificity of the combination of sST2、TGF-β1、CTGF to predict short-term adverse prognosis in HFpEF patients were significantly higher than each individual index(all P＜0.05).Conclusion:The combination of serum sST2,TGF-β1 and CTGF has a strong predictive value for the short-term adverse prognosis of HFpEF patients.
soluble suppression of tumorigenicity 2transforming growth factor-β1connective tissue growth factorheart failure with preserved ejection fractionpoor prognosis
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