Expression of plasma marinobufagenin and type Ⅰ collagen α1 chain levels and their correlation with prognosis in patients with chronic heart failure

doi:10.11958/20252440

Abstract

Abstract:

Objective To investigate the expression levels of plasma marinobufagenin (MBG) and type Ⅰ collagen α1 chain (COL1A1) in patients with chronic heart failure (CHF) and their correlation with prognosis. Methods A total of 126 patients with CHF (CHF group) and 63 healthy volunteers (control group) were enrolled. According to the New York Heart Association (NYHA) functional classification, CHF patients were divided into the class Ⅱ (n=48), the class Ⅲ (n=44), and the class Ⅳ (n=34) groups. Based on the 6-month follow-up outcomes, patients were classified into the poor prognosis and the good prognosis groups. Plasma MBG and COL1A1 levels were measured, and their relationships with NYHA classification and prognosis were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate predictive efficacy. Results Plasma MBG and COL1A1 levels were significantly higher in the CHF group than those in the control group (P<0.05). Among CHF patients, plasma MBG and COL1A1 levels increased progressively from NYHA class Ⅱ to Ⅳ (P<0.05) and were positively correlated with NYHA classification (P<0.05). During the 6-month follow-up, the incidence of poor prognosis in CHF patients was 31.75% (40/126). Multivariate logistic regression showed that NYHA class Ⅳ (OR=4.007, 95%CI: 1.858-8.643), N-terminal pro-B-type natriuretic peptide (OR=1.001, 95%CI: 1.000-1.001), MBG (OR=1.020, 95%CI: 1.010-1.030), and COL1A1 (OR=1.037, 95%CI: 1.017-1.056) were independent risk factors for poor prognosis (P<0.05). The area under the ROC curve (AUC) for the combined prediction of MBG and COL1A1 was 0.880 (95%CI: 0.810-0.931), which was superior to MBG (0.786, 95%CI: 0.704-0.854) or COL1A1 (0.797, 95%CI: 0.716-0.863) alone (P<0.05). Conclusion Elevated plasma MBG and COL1A1 levels are associated with impaired cardiac function and poor prognosis in CHF patients, and their combined measurement provides higher predictive value for adverse outcomes.

Key words: heart failure, prognosis, collagen type Ⅰ, marinobufagenin, cardiac function

CLC Number:

R541

Figures/Tables 6

References 25

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组别	n	性别（男/女）	年龄/ 岁	MBG/ （pmol/L）	COL1A1/ （μg/L）
对照组	63	40/23	57.30±13.16	234.22±52.98	147.94±40.28
CHF组	126	73/53	59.77±10.28	504.12±113.83	302.14±62.83
χ²或t		0.539	1.414	22.231^＊＊	20.408^＊＊

组别	n	性别（男/女）	年龄/ 岁	MBG/ （pmol/L）	COL1A1/ （μg/L）
对照组	63	40/23	57.30±13.16	234.22±52.98	147.94±40.28
CHF组	126	73/53	59.77±10.28	504.12±113.83	302.14±62.83
χ²或t		0.539	1.414	22.231^＊＊	20.408^＊＊

组别	n	MBG/（pmol/L）	COL1A1/（μg/L）
Ⅱ级组	48	423.77±93.11	260.27±50.54
Ⅲ级组	44	520.21±87.38^a	305.61±43.12^a
Ⅳ级组	34	596.74±90.63^ab	356.76±57.05^ab
F		72.745^＊＊	74.143^＊＊

组别	n	MBG/（pmol/L）	COL1A1/（μg/L）
Ⅱ级组	48	423.77±93.11	260.27±50.54
Ⅲ级组	44	520.21±87.38^a	305.61±43.12^a
Ⅳ级组	34	596.74±90.63^ab	356.76±57.05^ab
F		72.745^＊＊	74.143^＊＊

组别	n	性别（男/女）		年龄/ 岁		原发疾病（冠心病/ 扩张型心肌病/原发性高血压）		NYHA心功能分级（Ⅱ/Ⅲ/Ⅳ）		糖尿病	高血压		冠心病	心房颤动		高脂血症
良好组	86	48/38		58.74±11.35		33/18/35		46/29/11		22（25.6）	64（74.4）		40（46.5）	24（29.9）		21（24.4）
不良组	40	25/15		61.98±7.12		18/7/15		2/15/23		15（37.5）	31（77.5）		19（47.5）	18（45.0）		13（32.5）
χ²或t		0.501		1.944		0.529		6.053^＊＊		1.870	0.140		0.011	3.590		0.905
组别	吸烟史			饮酒史	收缩压/mmHg		舒张压/mmHg		LVEF	NT-proBNP/（ng/L）			血尿酸/（μmol/L）
良好组	25（29.1）			14（16.3）	137.74±16.68		82.28±13.62		0.50±0.06	2 381.24±914.44			482.28±150.95
不良组	17（42.5）			10（25.0）	143.55±16.31		86.58±16.77		0.48±0.04	3 393.68±1 197.70			502.93±172.52
χ²或t	2.216			1.347	1.516		1.529		1.916	5.227^＊＊			0.682
组别			血红蛋白/（g/L）		白蛋白/（g/L）		血肌酐/（μmol/L）		血尿素氮/（mmol/L）			MBG/（pmol/L）			COL1A1/（μg/L）
良好组			123.64±17.19		36.74±6.01		80.78±33.56		10.98±3.83			468.92±106.62			280.66±52.56
不良组			116.61±23.21		34.98±5.50		91.35±30.21		12.18±4.10			579.81±90.27			348.33±58.54
t			1.711		1.572		1.697		1.602			5.693^＊＊			6.486^＊＊