Objective To discuss the relationship among expressions of serum microRNA-497(miR-497)and silent information regulator 4(Sirt4),disease severity and prognosis in patients with chronic heart failure(CHF).Methods CHF patients(n=223)were chosen into CHF group from Hospital of Traditional Chinese Medicine of Langfang City from June 2021 to June 2022.The CHF groups were divided,according to NYHA classification of heart function(NYHA),into NYHA grade Ⅰ group(n=56),NYHA grade Ⅱ group(n=47),NYHA grade Ⅲ group(n=52)and NYHA grade Ⅳ group(n=68).The patients were divided,according to their prognosis conditions,into poor prognosis group and good prognosis group.The volunteers with health checkups(n=68)were chosen into control group in the same period.The clinical materials were collected from the patients.The expressions of serum miR-497 and Sirt4 were detected by using fluorescence quantitative polymerase chain reaction(qPCR)and enzyme-linked immunosorbent assay(ELISA).The correlation among miR-497,Sirt4 and NYHA was analyzed by using Spearman correlation analysis.The influence factors of poor prognosis were analyzed by using multi-factor Logistic regression analysis.The review value of miR-497 and Sirt4 expressions to poor prognosis was analyzed by using ROC curve.Results The expression of miR-497 was lower and Sirt4 expression was higher in CHF group than that in control group(all P<0.001).The expression of miR-497 decreased sequentially and Sirt4 expression increased sequentially in NYHA grade I group,NYHA grade Ⅱ group,NYHA grade Ⅲ group and NYHA grade Ⅳgroup(all P<0.001).The results of Spearman correlation analysis showed that miR-497 expression was negatively correlated to Sirt4 expression(rs=-0.729,P<0.001),and NYHA was negatively correlation to miR-497 expression(rs=-0.807,P<0.001)and positively correlated to Sirt4 expression(rs=0.895,P<0.001).The results of multi-factor Logistic regression analysis showed that age increasing(OR=1.047,95%CI:1.001～1.096,P=0.046),NYHA≥Ⅲ(OR=3.286,95%CI:1.325～8.145,P=0.010),increased N-terminal pro-brain natriuretic peptide(NT-proBNP,OR=1.110,95%CI:1.019～1.209,P=0.017)and increased Sirt4(OR=1.405,95%CI:1.092～1.807,P=0.008)were independent risk factors of poor prognosis in CHF patients,and increased miR-497(OR=0.839,95%CI:0.734～0.958,P=0.009)and left ventricular ejection fraction(LVEF,OR=0.855,95%CI:0.759～0.964,P=0.010)were independent protective factors.The results of ROC curve analysis showed that AUC of miR-497 combined with Sirt4 was 0.863(95%CI:0.811～0.905,P<0.001),which was higher than AUC of single miR-497(AUC=0.778,95%CI:0.717～0.830,P<0.001)and single Sirt4(AUC=0.786,95%CI:0.726～0.838,P<0.001)in reviewing poor prognosis(all P<0.05).Conclusion The lower expression of miR-497 and higher Sirt4 expression are closely correlated to severity of disease and prognosis in CHF patients.The value of miR-497 combined with Sirt4 is higher in reviewing poor prognosis in CHF patients.
关键词
慢性心力衰竭/微小RNA-497/沉默调节蛋白4/预后
Key words
Chronic heart failure/MicroRNA-497/Silent information regulator 4/Prognosis
维普
万方数据