慢性心力衰竭患者血清lncRNA ROR及miR⁃145水平与心房颤动发生的关联性分析

Analysis on the correlation of serum lncRNA ROR and miR-145 levels with the occurrence of atrial fibrillation in chronic heart failure patients

目的分析慢性心力衰竭(CHF)患者血清长链非编码核糖核酸(lncRNA)ROR、微小核糖核酸-145(miR-145)水平与心房颤动(AF)发生的关联性。方法招募2019年3月至2022年12月邯郸市第一医院收治的108例CHF患者,根据AF发生情况将其分为合并AF组(n=46)和未合并AF组(n=62),于同期纳入性别、年龄与CHF患者匹配的健康体检者50名作为对照组。采用实时荧光定量聚合酶链式反应(qRT-PCR)检测血清lncRNA ROR、miR-145表达水平,采用Pearson相关性分析探讨血清lncRNA ROR、miR-145表达水平与心功能指标的相关性,采用多因素logistic回归分析CHF患者AF发生的影响因素,通过受试者工作特征(ROC)曲线分析血清lncRNA ROR、miR-145对CHF患者AF发生的预测效能。结果与对照组比较,未合并AF组、合并AF组lncRNA ROR水平上调,且合并AF组高于未合并AF组,差异有统计学意义(P<0.05);未合并AF组、合并AF组miR-145水平下调,且合并AF组低于未合并AF组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,血清lncRNA ROR水平与左房内径(LAD)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)呈正相关(P<0.05),与左室射血分数(LVEF)呈负相关(P<0.05);miR-145水平与LAD、LVEDD、LVESD呈负相关(P<0.05),与LVEF呈正相关(P<0.05)。多因素logistic回归分析结果显示,纽约心脏病协会(NYHA)心功能分级Ⅳ级、LVEF下降、lncRNA ROR水平上调是促进CHF患者AF发生的独立危险因素(P<0.05),而miR-145水平上调是抑制CHF患者AF发生的独立保护因素(P<0.05)。ROC曲线分析结果显示,血清lncRNA ROR、miR-145表达水平能有效预测CHF患者AF发生,且两者联合的预测效能更优[AUC(95%CI)=0.814(0.730~0.897),P<0.001],其灵敏度和特异度分别为89.80%和72.00%。结论CHF患者血清lncRNA ROR、miR-145与AF的发生密切相关,二者联合检测对AF发生具有较高的预测价值。

Objective To analyze the correlation of serum long non-coding RNA(lncRNA)ROR and micro ribonucleic acid-145(miR-145)levels with the occurrence of atrial fibrillation(AF)in chronic heart failure(CHF)patients.Methods One hundred and eight CHF patients admitted to Handan First Hospital from March 2019 to December 2022 were recruited.The patients were divided into AF group(n=46)and non-AF group(n=62)according to the occurrence of AF.During the same period,50 healthy individuals who matched gender and age with the CHF patients were included as the control group.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression levels of serum lncRNA ROR and miR-145.Pearson correlation analysis was used to explore the correlation of serum lncRNA ROR and miR-145 expression levels with cardiac function indicators.Multivariate logistic regression was used to analyze the influencing factors of AF occurrence in the CHF patients.The predictive efficacy of serum lncRNA ROR and miR-145 in the occurrence of AF was analyzed for the CHF patients using receiver operating characteristic(ROC)curve.Results Compared with those in the control group,the levels of lncRNA ROR in the non-AF group and the AF group were up-regulated,and the AF group had higher levels of lncRNA ROR than the non-AF group,with a statistically significant difference(P<0.05).Compared with those in the health group,the levels of miR-145 in the non-AF group and the AF group were down-regulated,and the AF group had lower levels of miR-145 than the non-AF group,with a statistically significant difference(P<0.05).The results of Pearson correlation analysis showed that serum lncRNA ROR levels were positively correlated with left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),and left ventricular end systolic diameter(LVESD)(P<0.05),and negatively correlated with left ventricular ejection fraction(LVEF)(P<0.05).The level of miR-145 was negatively correlated with LAD,LVEDD and LVESD(P<0.05),and positively correlated with LVEF(P<0.05).The results of multivariate logistic regression analysis showed that New York Heart Association(NYHA)classification cardiac function classⅣ,decreased LVEF,and up-regulated lncRNA ROR level were independent risk factors for promoting the occurrence of AF in the CHF patients(P<0.05),while up-regulated miR-145 level was an independent protective factor for inhibiting the occurrence of AF in the CHF patients(P<0.05).The results of ROC curve analysis showed that the expression levels of serum lncRNA ROR and miR-145 could effectively predict the occurrence of AF in the CHF patients,and the combination of the two indicators had better predictive efficacy[AUC(95%CI)=0.814(0.730-0.897),P<0.001],and the sensitivity and the specificity were 89.80%and 72.00%,respectively.Conclusion Serum lncRNA ROR and miR-145 are closely related to the occurrence of AF in CHF patients.The combined detection of the two indicators has higher predictive value for the occurrence of AF.