Evaluation value of QRS complex time limit combined with serum angptl2, angptl7 and sST2 for short-term prognosis of patients with acute heart failure

doi:10.11958/20230053

Abstract

Abstract:

Objective To investigate the prognostic value of QRS complex duration combined with serum angiopoietin-like protein (angptl)2, angptl7 and soluble tumor suppressor factor 2 (sST2) in patients with acute heart failure (AHF). Methods A total of 104 patients with AHF were collected as the case group, and their baseline data were recorded. According to the American New York Heart Association (NYHA) classification, patients were divided into the class Ⅱ group, the class Ⅲ group and the class Ⅳ group. According to the prognosis, patients were grouped into the good prognosis group and the poor prognosis group, and 98 healthy subjects in our hospital were collected as the control group. The QRS complex time limit was measured by electrocardiograph, and serum levels of angptl2, angptl7 and sST2 were detected by enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of QRS complex duration combined with serum angptl2, angptl7 and sST2 levels on the prognosis of patients with AHF. Multivariate Cox regression was used to analyze influencing factors of poor prognosis in patients with AHF. Results The QRS complex time limit and serum levels of angptl2, angptl7 and sST2 were higher in the case group than those in the control group (P<0.05). The QRS complex time limit and serum levels of angptl2, angptl7 and sST2 in the grade Ⅱ group, the grade Ⅲ group and the grade Ⅳ group were increased in turn (P<0.05). The NYHA classification, left ventricular end diastolic dimension (LVEDD), QRS complex time limit and serum levels of angptl2, angptl7 and sST2 were greatly higher in the poor prognosis group than those in the good prognosis group, and the left ventricular ejection fraction (LVEF) was greatly lower in the poor prognosis group than that in the good prognosis group (P<0.05). The AUC of QRS complex time limit, serum angptl2, angptl7, sST2 and the combined prediction of poor prognosis in patients with AHF were 0.773, 0.767, 0.833, 0.743 and 0.907, respectivily. High NYHA class and high sST2 were independent risk factors for poor prognosis in patients with AHF (P<0.05). Conclusion The QRS complex duration, serum levels of angptl2, angptl7 and sST2 in AHF patients increase with the worsening of the disease. NYHA grading and sST2 are independent factors for poor short-term prognosis in AHF patients.

Key words: heart failure, acute disease, angiopoietin-like proteins, prognosis, QRS complex duration, sST2

CLC Number:

R541.6，R445.1

Figures/Tables 8

References 15

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组别	n	QRS波群时限/ms	angptl2/（μg/L）	angptl7/（ng/L）	sST2/（mg/L）
对照组	98	86.42±17.94	1.82±0.39	172.43±25.61	89.36±15.71
病例组	104	130.46±25.79	4.62±1.45	696.45±87.63	209.48±60.22
t		14.002^＊＊	18.494^＊＊	56.944^＊＊	19.140^＊＊

组别	n	QRS波群时限/ms	angptl2/（μg/L）	angptl7/（ng/L）	sST2/（mg/L）
对照组	98	86.42±17.94	1.82±0.39	172.43±25.61	89.36±15.71
病例组	104	130.46±25.79	4.62±1.45	696.45±87.63	209.48±60.22
t		14.002^＊＊	18.494^＊＊	56.944^＊＊	19.140^＊＊

组别	n	QRS波群时限/ms	angptl2/（μg/L）	angptl7/（ng/L）	sST2/（mg/L）
Ⅱ级组	39	119.75±15.32	3.82±1.28	645.84±67.16	180.36±30.79
Ⅲ级组	44	132.18±23.45^a	4.65±1.42^a	704.26±86.15^a	210.45±43.28^a
Ⅳ级组	21	146.75±30.36^ab	6.04±1.67^ab	774.08±92.49^ab	261.38±56.42^ab
F		10.077^＊＊	16.610^＊＊	17.489^＊＊	25.127^＊＊

组别	n	QRS波群时限/ms	angptl2/（μg/L）	angptl7/（ng/L）	sST2/（mg/L）
Ⅱ级组	39	119.75±15.32	3.82±1.28	645.84±67.16	180.36±30.79
Ⅲ级组	44	132.18±23.45^a	4.65±1.42^a	704.26±86.15^a	210.45±43.28^a
Ⅳ级组	21	146.75±30.36^ab	6.04±1.67^ab	774.08±92.49^ab	261.38±56.42^ab
F		10.077^＊＊	16.610^＊＊	17.489^＊＊	25.127^＊＊

组别		n	男性		年龄/岁		BMI/（kg/m²）			吸烟史		饮酒史		高血压		糖尿病	LVEF		LVEDD/mm
预后良好组		76	39（51.3）		62.54±10.13		23.42±3.65			35（46.1）		18（23.7）		47（61.8）		20（26.3）	0.57±0.05		46.72±4.48
预后不良组		28	16（57.1）		60.17±9.85		24.01±3.59			13（46.4）		7（25.0）		19（67.9）		8（28.6）	0.39±0.04		55.94±5.12
χ²或t			0.279		1.066		0.734			0.001		0.019		0.319		0.053	17.121^＊＊		8.954^＊＊
组别	NYHA分级							服用药物					病因
组别	Ⅱ级			Ⅲ级		Ⅳ级		β受体阻滞剂	利尿剂		血管紧张素系统阻滞剂		心肌病		缺血性心脏病			肺源性心脏病		心脏瓣膜病
预后良好组	36（47.4）			34（44.7）		6（7.9）		68（89.5）	64（84.2）		62（81.6）		28（36.8）		17（22.4）			9（11.8）		22（29.0）
预后不良组	3（10.7）			10（35.7）		15（53.6）		26（92.7）	24（85.7）		24（85.7）		10（35.7）		6（21.4）			5（17.9）		7（25.0）
χ²或t	28.866^＊＊							0.270	0.036		0.244		0.680