Correlation of serum rheumatoid factor and autophagy-related gene 7 levels with cardiac function and immune inflammation in patients with rheumatic heart disease
Objective To investigate the expression of rheumatoid factor(RF)and autophagy-related gene 7(Atg7)in the serum of patients with rheumatic heart disease and their correlation with cardiac function and immune inflammation.Methods One hundred and two patients with rheumatic heart disease admitted to Xiantao First People's Hospital Affiliated to Yangtze University,from May 2018 to May 2021 were selected as the observation group.Based on their heart function,patients were classified into grade Ⅳ group(34 cases),grade Ⅲ group(36 cases),and grade Ⅱgroup(32 cases)according to the New York Heart Association(NYHA)classification.One hundred healthy physical examiners matched for age and gender were randomly selected as the control group.General information was collected,and serum levels of RF,Atg7 and immune inflammation markers were detected,along with cardiac ultrasound examinations.Pearson correlation analysis was performed to evaluate the correlation of RF and Atg7 with cardiac function and immune inflammation markers.ROC curve was employed to assess the diagnostic value of serum RF and Atg7 levels in patients with rheumatic heart disease.Results Serum RF and Atg7 expression levels in the observation group were higher than those in the control group,and the differences were statistically significant(t=72.872,15.973;both P<0.05).Patients in grades Ⅳ group and grade Ⅲ group had higher levels of RF,Atg7,and left ventricular end-diastolic diameter(LVEDD)and lower left ventricular ejection fraction(LVEF)compared to grade Ⅱ group,with statistically significant differences(P<0.05).Patients in grades Ⅳ group had higher levels of RF,Atg7 and LVEDD and lower LVEF compared to grade Ⅲ group,and the differences were statistically significant(P<0.05).Serum RF and Atg7 expressions in patients with rheumatic heart disease were positively correlated(r=0.463,P<0.05).Serum RF and Atg7 expressions in patients with rheumatic heart disease were positively correlated with high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),erythrocyte sedimentation rate(ESR),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),and LVEDD,while negatively correlated with LVEF(P<0.05).The areas under the ROC curve of serum RF and Atg7 levels for predicting patients with rheumatic heart disease were 0.856(95%CI=0.799-0.901)and 0.843(95%CI=0.786-0.890),respectively,with corresponding sensitivities of 84.31%and 86.27%,and specificities of 89.00%and 83.00%,respectively.The combined detection of RF and Atg7 in patients with rheumatic heart disease yielded an area under the ROC curve of 0.933(95%CI=0.889-0.963),with sensitivity and specificity of 87.25%and 86.00%,respectively.Conclusion RF and Atg7 are highly expressed in the serum of patients with rheumatic heart disease,and are closely related to cardiac function and immune inflammation.
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