miR-29a与慢性心力衰竭患者心室重构的相关性及对预后的评估价值

Correlation between miR-29a and ventricular remodeling in patients with chronic heart failure and its value in prognostic evaluation

目的研究miR-29a与慢性心力衰竭(CHF)患者心室重构的相关性及对预后的评估价值。方法将280例CHF患者纳入CHF组,同期入院的60例心功能Ⅰ级患者纳入CK1组,60例健康体检者纳入CK2组。比较三组的心室重构指标和miR-29a水平,分析miR-29a与心室重构指标的相关性及对预后的评估价值。结果CHF组的LVEF低于CK1组和CK2组,LVEDd、LVPWT、LVMI和miR-29a水平均高于CK1组和CK2组(P<0.05)。LVEF与miR-29a呈明显负相关,LVEDd、LVPWT、LVMI与miR-29a呈明显正相关(P<0.05)。miR-29a预测CHF患者预后的曲线下面积为0.836,当miR-29a为4.38时,灵敏度为71.00%,特异度为95.00%。以4.38为临界值对CHF患者进行危险分层,发现高危组和低危组的无MACE生存曲线比较,差异具有统计学意义(P<0.05)。结论miR-29a在CHF患者中高表达,与CHF患者心室重构密切相关,并可作为CHF患者预后判断的敏感性指标。

Objective To study the correlation between miR-29a and ventricular remodeling in patients with chronic heart failure(CHF)and its value in prognostic evaluation.Methods A total of 280 CHF patients were included in CHF group,60 patients with cardiac function gradeⅠadmitted in the hospital during the same period were included in CK1 group,and 60 healthy subjects were included in CK2 group.The ventricular remodeling indexes and miR-29a level of the three groups were compared,and the correlation between miR-29a and ventricular remodeling indexes and its value in prognostic evaluation were analyzed.Results The LVEF of the CHF group was lower than that of the CK1 and CK2 groups,and the LVEDd,LVPWT,LVMI and miR-29a level were higher than those of the CK1 and CK2 groups(P<0.05).LVEF was significantly negatively correlated with miR-29a,and LVEDd,LVPWT and LVMI were significantly positively correlated with miR-29a(P<0.05).The area under the curve for miR-29a to predict the prognosis of CHF patients was 0.836.When miR-29a was 4.38,the sensitivity was 71.00%,and the specificity was 95.00%.The risk stratification of CHF patients was carried out with 4.38 as the critical value,and it was found that there was a significant difference in the survival curve without MACE between the high-risk group and the low-risk group(P<0.05).Conclusion miR-29a was highly expressed and was closely related to ventricular remodeling in CHF patients,which could be used as a sensitive index for prognostic judgment of CHF patients.