Study of the Relationship between Serum Apelin,CD40L,Gal-3 and Ventricular Arrhythmia after Cardiac Resynchronization Therapy in Patients with Chronic Heart Failure and its Predictive Value
Objective:To investigate the relationship between serum apelin(Apelin),cluster of differentiation 40 ligand(CD40L),galectin-3(Gal-3)and ventricular arrhythmia after cardiac resynchronization therapy(CRT)in patients with chronic heart failure(CHF)and its predictive value.Methods:235 CHF patients who underwent CRT at Taigang General Hospital Affiliated to Shanxi Medical University and Cardiovascular Hospital Affiliated to Shanxi Medical University from January 2018 to October 2022 were selected as the CHF group.In addition,150 healthy individuals who underwent physical examinations at the two hospitals during the same period were selected as the control group.The serum Apelin,CD40L and Gal-3 levels of all subjects were detected and compared.CHF patients were followed up for 1 year after CRT,and patients were divided into ventricular arrhythmia group(48 cases)and non-ventricular arrhythmia group(187 cases)according to whether ventricular arrhythmia occurred.The influencing factors of ventricular arrhythmia after CRT in CHF patients were analyzed by multivariate Logistic regression.The value of serum Apelin,CD40L and Gal-3 in predicting the occurrence of ventricular arrhythmias after CRT in CHF patients were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with control group,the serum Apelin level in CHF group was decreased,and the levels of CD40L and Gal-3 were increased(P＜0.05).After 1 year of follow-up,the incidence of ventricular arrhythmia after CRT in 235 CHF patients was 20.43％.Increased Apelin was protective factors for ventricular arrhythmias after CRT in CHF patients,and the New York Heart Association(NYHA)cardiac function classification IV and CD40L,Gal-3 increased were risk factors(P＜0.05).The area under the curve(AUC)of combined serum Apelin,CD40L and Gal-3 in predicting the occurrence of ventricular arrhythmia after CRT in CHF patients was 0.911,which was greater than 0.770,0.754 and 0.760 predicted by serum Apelin,CD40L and Gal-3 alone.Conclusion:The decrease of serum Apelin level and the increase of CD40L and Gal-3 levels in CHF patients are relate to the occurrence of ventricular arrhythmia after CRT,the combine detection of serum Apelin,CD40L and Gal-3 levels has a high predictive value for the occurrence of ventricular arrhythmia after CRT in CHF patients.
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