circRNA_000203与心力衰竭患者心功能及预后的关系研究

Study on the relationship between circRNA_000203 and heart function and prognosis in patients with heart failure

目的探讨环状RNA(circRNA)_000203与心力衰竭(简称心衰)患者心功能及预后的关系。方法选取2017年6月至2019年1月该院收治的124例急性心衰患者作为心衰组,心衰患者根据纽约心脏病协会(NYHA)分级:Ⅱ级36例,Ⅲ级45例,Ⅳ级43例;另选取同期该院体检中心体检的120例体检健康者作为对照组。荧光定量聚合酶链反应技术(FQ-PCR)检测circRNA_000203表达水平。心衰不良预后定义为再次发生心衰或死亡。建立Logistic多因素模型分析影响心衰预后的因素;绘制受试者工作特征曲线(ROC)分析circRNA_000203预测预后的价值,计算曲线下面积(AUC)、特异度和灵敏度。结果心衰组circRNA_000203、氨基末端脑钠肽前体(NT-proBNP)、左心房内径(LAD)、左心室舒张末期内径(LVDd)高于对照组,而左心室射血分数(LVEF)低于对照组,差异有统计学意义(P<0.05)。Ⅱ级、Ⅲ级、Ⅳ级心衰患者血清circRNA_000203相对表达水平分别为1.89±0.87、2.97±0.69、4.57±1.03,差异有统计学意义(P<0.05),分级越高,血清circRNA_000203表达水平越高。circRNA_000203表达水平与NT-proBNP、LAD、LVDd呈正相关关系,而与LVEF呈负相关关系(r分别为0.678、0.411、0.409、-0.555,P<0.05)。124例患者中预后不良44例,其中再发心衰30例,死亡14例。预后不良患者circRNA_000203相对表达水平为4.56±1.10,高于预后良好患者1.90±0.94,差异有统计学意义(P<0.05)。circRNA_000203、NT-proBNP、LAD、LVDd和LVEF是影响心衰患者预后的独立因素(P<0.05)。circRNA_000203预测心衰患者不良预后的AUC为0.756,灵敏度和特异度分别为65.03%和88.95%。结论心衰患者血清circRNA_000203表达水平升高,检测其表达水平可能有助于评估心功能和患者预后。

Objective To explore the relationship between circularRNA(circRNA)_000203 and heart function and prognosis of patients with heart failure.Methods One hundred and twenty-four patients with acute heart failure admitted to our hospital from June 2017 to January 2019 were selected as the heart failure group,including 36 patients with heart failure classified as gradeⅡ,45 patients as gradeⅢand 43 patients as gradeⅣby New York Heart Association(NYHA);another 120 healthy people were selected as the control group.Fluorescent quantitative polymerase chain reaction(FQ-PCR)was used to detect circRNA_000203 expression level.Adverse prognosis of heart failure is defined as recurrence of heart failure or death.Logistic multivariate model was established to analyze the prognostic factors of heart failure;receiver operating characteristic curve(ROC)was drawn to analyze the prognostic value of circRNA_000203,and area under curve(AUC),specificity and sensitivity were calculated.Results CircRNA_000203,N-terminal pro-brain natriuretic peptide(NT-proBNP),left atrial inner diameter(LAD),left ventricular end-diastolic diameter(LVDd)were higher in the heart failure group than the control group,while left ventricular ejection fraction(LVEF)lower than the control group,the differences were statistically significant(P<0.05).The expression levels of serum circRNA_000203 in patients with gradeⅡ,Ⅲ,andⅣheart failure were 1.89±0.87,2.97±0.69,4.57±1.03,respectively,and the difference was statistically significant by analysis of variance(P<0.05).The higher the grade,the higher the expression level of serum circRNA_000203.The expression of circRNA_000203 was positively correlated with NT-proBNP,LAD,and LVDd,but negatively correlated with LVEF(r values were 0.678,0.411,0.409,-0.555,P<0.05).Among the 124 patients,44 had a poor prognosis,including 30 recurrent heart failure and 14 deaths.The expression level of circRNA_000203 in patients with poor prognosis was 4.56±1.10,which was higher than that in patients with good prognosis 1.90±0.94,the difference was statistically significant(P<0.05).circRNA_000203,NT-proBNP,LAD,LVDd and LVEF were independent factors affecting the prognosis of patients with heart failure,the difference was statistically significant(P<0.05).The AUC of circRNA_000203 predicting the poor prognosis of patients with heart failure is 0.756,and the sensitivity and specificity are 65.03%and 88.95%,respectively.Conclusion The expression level of serum circRNA_000203 in patients with heart failure is elevated,and detection of its expression level may be helpful to assess heart function and patient prognosis.