Relationship between serum levels of follistatin-like protein 1 and Dickkopf related protein 3 with ventricular remodeling and prognosis in elderly patients with chronic heart failure
Objective To investigate the relationship between serum levels of follistatin-like protein 1(FSTL-1)and Dickkopf related protein 3(DKK3)with ventricular remodeling and prognosis in elderly patients with chronic heart failure(CHF).Methods A total of 142 elderly patients with CHF admitted to Lujiang County Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were selected as CHF group.According to the New York Heart Association(NYHA)cardiac function classification,the CHF patients were grouped into grade Ⅱ(61 cases),grade Ⅲ(46 cases),and grade Ⅳ(35 cases).According to the follow-up results,the CHF patients were divided into poor prognosis group(48 cases)and good prognosis group(94 cases).Additionally,142 healthy individuals who underwent physical examinations at the hospital during the same period were included as the control group.ELISA method was applied to measure serum FSTL-1 and DKK3 levels.Color Doppler ultrasound was applied to measure cardiac function indexes.Serum levels of FSTL-1 and DKK3 were compared between the CHF group and the control group,among different heart function classifications,and between different prognostic outcomes of CHF patients.Pearson correlation was applied to analyze the relationship between serum FSTL-1 and DKK3 levels with cardiac function indicators.Logistic regression analysis was performed to analyze the influencing factors for poor prognosis in CHF patients.ROC curve was applied to assess the predictive value of serum FSTL-1 and DKK3 for poor prognosis in elderly CHF patients.Results Serum levels of FSTL-1,left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),and left ventricular mass index(LVMI)in the CHF group were higher compared to those in the control group,while left ventricular ejection fraction(LVEF)and serum levels of DKK3 were lower(t=35.771,39.686,25.148,14.262,35.767,18.208;P<0.05).With the increase in NYHA classification,serum levels of FSTL-1,LVEDD,LAD,and LVMI gradually increased in CHD patients(F=86.720,239.493,114.340,16.883;P<0.05),while serum levels of DKK3 and LVEF gradually decreased(F=89.083,217.157;P<0.05).Pearson correlation analysis showed that serum levels of FSTL-1 were positively correlated with LVEDD,LAD,and LVMI(r=0.630,0.568,0.404;P<0.01)and negatively correlated with LVEF(r=-0.642,P<0.01).Serum levels of DKK3 were negatively correlated with LVEDD,LAD,and LVMI(r=-0.580,-0.593,-0.467;P<0.01)and positively correlated with LVEF(r=0.621,P<0.01).Multivariate Logistic regression analysis showed that heart function classification,LVEF,LVEDD,LAD,LVMI,FSTL-1,and DKK3 were influencing factors for poor prognosis in CHF patients[OR(95%CI)=1.422(1.043-1.938),0.621(0.401-0.961),1.353(1.024-1.787),1.227(1.023-1.472),1.531(1.159-2.022),1.472(1.095-1.979),0.724(0.544-0.964);P<0.05].ROC curve analysis showed that the sensitivity and specificity of serum FSTL-1 combined with DKK3 in predicting poor prognosis in elderly CHF patients were 86.8%and 82.4%,respectively,with an AUC of 0.959,which was higher than that of FSTL-1 or DKK3 alone(Z=2.300,2.006;P<0.05).Conclusion Serum levels of FSTL-1 and DKK3 are closely related to ventricular remodeling and prognosis in elderly CHF patients.Both could potentially serve as biological indicators for the evaluation of ventricular remodeling and prognosis in clinical practice.
Elderly chronic heart failureSerum follistatin-like protein 1Dickkopf related protein 3Ventricular remodelingPrognosis
万方数据
维普
