实时三维超声心动图联合microRNA-499水平检测对心力衰竭的诊断价值

Diagnostic value of real-time three-dimensional echocardiography combined with miR-499 level for heart failure

目的探讨实时三维超声心动图(RT-3DE)联合miR-499水平检测对心力衰竭的诊断价值。方法选取2018年1月—2021年12月就诊于青岛市中医医院的110例心力衰竭患者作为心衰组,另选同期该院健康体检者60例作为对照组。通过RT-3DE测定心功能指标[左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左室16节段达到收缩末期最小容积的标准差(Tmsv16-SD%)、最大差值(Tmsv16-Dif%)],采用实时荧光定量聚合酶链反应测定血清miR-499相对表达量。比较两组RT-3DE检查参数与miR-499相对表达量,Pearson法分析RT-3DE检查参数与miR-499相对表达量的相关性,受试者工作特征(ROC)曲线分析RT-3DE参数、血清miR-499相对表达量及联合诊断对心衰的诊断效能。结果两组性别、体质量指数、心率、收缩压、舒张压比较,差异无统计学意义(P>0.05)。心衰组LVEDV、LVESV、Tmsv16-Dif%、Tmsv16-SD%及血清miR-499相对表达量高于对照组,LVEF低于对照组(P<0.05)。Pearson相关性分析显示,心衰患者血清miR-499相对表达量与LVEDV、LVESV、Tmsv16-Dif%、Tmsv16-SD%均呈正相关(r=0.373、0.347、0.228和0.395,均P<0.05),与LVEF呈负相关(r=-0.341,P<0.05)。ROC曲线显示,联合诊断的AUC、敏感性、特异性最高,分别为0.932(95%CI:0.912,0.984)、0.855(95%CI:0.796,0.908)、0.832(95%CI:0.763,0.896)。结论心衰患者血清miR-499水平呈高表达,与RT-3DE参数密切相关,且两者联合对心衰有良好的诊断价值。

Objective To analyze the diagnostic value of real-time three-dimensional echocardiography(RT-3DE)combined with miR-499 level in patients with heart failure.Methods A total of 110 patients with heart failure treated in Qingdao Hospital of Traditional Chinese Medicine from January 2018 to December 2021 were selected as the heart failure group,and 60 healthy people undergoing heath checkup in the hospital during the same period were selected as the control group.Cardiac function parameters,including left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),and standard deviation(Tmsv16-SD%)and maximum difference(Tmsv16-Dif%)of the time to the minimal systolic volume of the 16 left ventricular segments,were measured by RT-3DE.The serum level of miR-499 was measured by quantitative real-time polymerase chain reaction(qRT-PCR).The cardiac function parameters measured via RT-3DE and the serum level of miR-499 were compared between the two groups.The correlations between cardiac function parameters and the miR-499 level were analyzed by Pearson method.The diagnostic efficacy of cardiac function parameters measured via RT-3DE,the serum level of miR-499,and their combination for heart failure was analyzed by the receiver operating characteristic(ROC)curve.Results There was no difference in the gender composition,body mass index,heart rate,systolic pressure,or diastolic pressure between the two groups(P>0.05).The LVEDV,LVESV,Tmsv16-Dif%,Tmsv16-SD%and the serum level of miR-499 in the heart failure group were higher than those in the control group,while LVEF in the heart failure group was lower than that in the control group(P<0.05).Pearson correlation analysis showed that the serum level of miR-499 was positively correlated with LVEDV(r=0.373),LVESV(r=0.347),Tmsv16-Dif%(r=0.228),and Tmsv16-SD%(r=0.395)(all P<0.05),but was negatively correlated with LVEF(r=-0.341)in patients with heart failure(P<0.05).The ROC curve analysis exhibited that the area under the ROC curve(AUC),sensitivity and specificity of the combination of cardiac function parameters measured via RT-3DE and the serum level of miR-499 were all the highest,and were 0.932(95%CI:0.912,0.984),0.855(95%CI:0.796,0.908)and 0.832(95%CI:0.763,0.896),respectively.Conclusions The serum level of miR-499 is high in patients with heart failure,and is closely related to the cardiac functions measured via RT-3DE.The combination of cardiac function parameters measured via RT-3DE and the serum level of miR-499 is of great diagnostic value for heart failure.