Study on Serum WWP1 and NLRP3 Expression Levels and Their Clinical Value in Patients with Heart Failure with Preserved Ejection Fraction
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维普
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目的 探讨WW结构域E3 泛素蛋白连接酶1(WW domain-containing E3 ubiquitin protein ligase 1,WWP1)和核苷酸结合寡聚化结构域样受体蛋白 3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)在射血分数保留心力衰竭(heart failure with preserved ejection fraction,HFpEF)患者血清中的表达水平及临床意义.方法 选取华北医疗健康集团峰峰总医院 2021 年 1 月～2022 年 9 月收治的 153 例HFpEF患者为观察组,并根据患者纽约心脏病协会(New York Heart Association,NYHA)心功能分级分为心功能分级Ⅰ～Ⅱ级组(n=64)和心功能分级Ⅲ～Ⅳ级组(n=89),另选取同期体检健康的 148 例志愿者为对照组.血清WWP1,NLRP3 水平与患者心功能指标的相关性采用Pearson分析;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清WWP1 和NLRP3水平对HFpEF患者心衰严重程度的诊断价值.结果 与对照组比较,观察组血清WWP1(1.68±0.35 vs 1.04±0.19)和NLRP3(6.72±1.26 ng/ml vs 4.57±0.84 ng/ml)表达水平明显升高,差异具有统计学意义(t=19.623,17.359,均P＜0.05);与心功能分级Ⅰ～Ⅱ级组比较,心功能分级Ⅲ～Ⅳ级组血清WWP1(1.87±0.39 vs 1.42±0.32)和NLRP3(7.53±1.40 ng/ml vs 5.59±1.18 ng/ml)表达水平明显升高,差异具有统计学意义(t=7.744,9.017,均P＜0.05);心功能分级Ⅰ～Ⅱ级组与心功能分级Ⅲ～Ⅳ级组心率、左心房内径(left atrial diameter,LAD)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左室舒张末期后壁厚度(left ventricular end-diastolic posterior wall thickness,LVPWT)、左心室射血分数(left ventricular ejection fraction,LVEF)、二尖瓣舒张早期流速峰值(peak mitral early diastolic velocity,E)/舒张晚期流速峰值(peak late diastolic velocity,A)以及心房颤动发生率比较差异均具有统计学意义(t/χ2=2.757～7.069,均P＜0.05);HFpEF患者血清WWP1 水平与LAD,LVEDD,LVPWT呈正相关(r=0.547,0.471,0.536,均P＜0.05),与LVEF和E/A呈负相关(r=-0.485,-0.417,均P＜0.05);血清NLRP3 水平与LAD,LVEDD,LVPWT呈正相关(r=0.534,0.494,0.520,均P＜0.05),与LVEF和E/A呈负相关(r=-0.462,-0.523,均P＜0.05).ROC结果显示,血清WWP1 和NLRP3 水平单独诊断HFpEF患者心衰严重程度的曲线下面积(area under the curve,AUC)分别为 0.825 和 0.855,两者联合诊断的AUC(0.924)显著大于血清WWP1 和NLRP3 水平单独诊断的AUC(Z=3.600,P<0.001;Z=3.053,P=0.002).结论 血清WWP1 和NLRP3 水平在HFpEF患者中明显升高,且与患者心功能密切相关,血清WWP1和NLRP3 对HFpEF患者心衰严重程度具有一定的诊断价值.
Objective To investigate the expression level and clinical significance of WW domain-containing E3 ubiquitin protein ligase 1(WWP1)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)in patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 153 patients with HFpEF admitted to Fengfeng General Hospital of North China Medical and Health Group from January 2021 to September 2022 were collected as the observation group.According to the New York Heart Association(NYHA)cardiac function grading of patients,they were grouped into cardiac function grading Ⅰ～Ⅱ group(n=64)and cardiac function grading Ⅲ～Ⅳ group(n=89),while 148 healthy volunteers were collected as the control group.The correlation between serum WWP1 and NLRP3 levels and cardiac function indexes of patients was explored by Pearson analysis.The diagnostic value of serum WWP1 and NLRP3 levels on the severity of heart failure in HFpEF patients was analyzed by the receiver operating characteristic(ROC)curve.Results Compared with the control group,the expression levels of WWP1(1.68±0.35 vs 1.04±0.19)and NLRP3(6.72±1.26 ng/ml vs 4.57±0.84 ng/ml)in the observation group were significantly increased,and the differences were statistically significant(t=19.623,17.359,all P<0.05).Compared with grade Ⅰ to Ⅱ groups,WWP1(1.87±0.39 vs 1.42±0.32)and NLRP3(7.53±1.40 ng/ml vs 5.59±1.18 ng/ml)expression levels in grade Ⅲ to Ⅳ groups were significantly increased and the differences were statistically significant(t=7.744,9.017,all P<0.05).The differences of heart rate,left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic posterior wall thickness(LVPWT),left ventricular ejection fraction(LVPWT),left ventricular ejection fraction(LVEF),peak mitral early diastolic velocity(E)/peak late diastolic velocity(A)and the incidence of atrial fibrillation between the cardiac function grade Ⅰ to Ⅱ groups and the grade Ⅲ to Ⅳ groups were significant(t/χ2=2.757～7.069,all P<0.05).Serum WWP1 level in HFpEF patients was positively correlated with LAD,LVEDD and LVPWT(r=0.547,0.471,0.536,all P<0.05),and negatively correlated with LVEF and E/A(r=-0.485,-0.417,all P<0.05).Serum NLRP3 level was positively correlated with LAD,LVEDD and LVPWT(r=0.534,0.494,0.520,all P<0.05),and negatively correlated with LVEF and E/A(r=-0.462,-0.523,all P<0.05).ROC results showed that the area under the curve(AUC)of serum WWP1 and NLRP3 levels alone for diagnosing the severity of heart failure in HFpEF patients was 0.825 and 0.855,respectively,and the AUC(0.924)diagnosed by the combination of the two was significantly greater than that diagnosed by the serum WWP1 alone and the AUC diagnosed by the NLRP3 alone(Z=3.600,P<0.001;Z=3.053,P=0.002).Conclusion The levels of serum WWP1 and NLRP3 were increased in patients with HFpEF,which were closely related to the cardiac function of patients.Serum WWP1 and NLRP3 have certain diagnostic value for the severity of heart failure in patients with HFpEF.
heart failure with preserved ejection fractionWW domain-containing E3 ubiquitin protein ligase 1nucleotide-binding oligomerization domain-like receptor protein 3
维普
万方数据
