慢性心力衰竭合并心房颤动患者血清ROCK1、HDAC3的表达及其临床意义

Expression and Clinical Significance of Serum ROCK1 and HDAC3in Patients with Chronic Heart Failure with Atrial Fibrillation

目的:探讨慢性心力衰竭(CHF)合并心房颤动(AF)患者血清Rho关联含卷曲螺旋蛋白激酶1(ROCK1)、组蛋白去乙酰化酶3(HDAC3)的表达及其临床意义。方法:选取2021年1月~2022年9月武汉科技大学附属普仁医院收治的312例CHF患者,根据是否合并AF分为AF组115例和非AF组197例,根据预后的不同将CHF合并AF患者分为预后不良组和预后良好组。比较AF组与非AF组血清ROCK1、HDAC3水平和心功能指标[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心房内径(LAD)]。通过Pearson相关性分析CHF合并AF患者血清ROCK1、HDAC3水平与心功能指标的相关性,多因素Logistic回归分析CHF合并AF患者预后不良的影响因素,受试者工作特征(ROC)曲线分析血清ROCK1、HDAC3水平对CHF合并AF患者预后不良的预测价值。结果:与非AF组比较,AF组血清ROCK1、HDAC3水平和LVEDD、LAD升高,LVEF降低(P<0.05)。Pearson相关性分析显示,CHF合并AF患者血清ROCK1、HDAC3水平与LVEF呈负相关,与LVEDD、LAD呈正相关(P<0.05)。随访3个月,115例AF患者预后不良发生率为26.96%。多因素Logistic回归分析显示,纽约心脏协会心功能分级≥Ⅲ级和N末端前体B型钠尿肽(NT-proBNP)、ROCK1、HDAC3升高为CHF合并AF患者预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,血清ROCK1、HDAC3水平联合预测CHF合并AF患者预后不良的曲线下面积为0.897,大于单一指标预测。结论:CHF合并AF患者血清ROCK1、HDAC3表达升高,与心功能和预后密切相关,血清ROCK1、HDAC3联合预测CHF合并AF患者预后不良的价值较高。

Objective:To investigate the expression and clinical significance of serum Rho associated coiled coil containing protein kinase 1(ROCK1)and histone deacetylase 3(HDAC3)in patients with chronic heart failure(CHF)with atrial fibrillation(AF).Methods:312 CHF patients admitted to Puren Hospital Affiliated to Wuhan University of Science and Technology from January 2021 to September 2022 were selected,patients were divided into AF group(n=115)and no AF group(n=197)according to whether patients had AF,and CHF patients with AF were divided into poor prognosis group and good prognosis group according to the different prognosis.The levels of serum ROCK1,HDAC3 and cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)]were compared between AF group and no AF group.The correlation between serum ROCK1,HDAC3 levels and cardiac function indexes in CHF patients with AF were analyzed by Pearson correlation analysis,the influencing factors of poor prognosis in CHF patients with AF were analyzed by multivariate Logistic regression analysis,the predictive value of serum ROCK1 and HDAC3 levels for poor prognosis in CHF patients with AF was analyzed by receiver operating characteristic(ROC)curve.Results:Compared with no AF group,the levels of serum ROCK1 and HDAC3,LVEDD and LAD were increased,and LVEF was decreased in AF group(P<0.05).Pearson correlation analysis showed that,serum ROCK1 and HDAC3 levels in CHF patients with AF were negatively correlated with LVEF,and positively correlated with LVEDD and LAD(P<0.05).After 3 months of follow-up,the incidence of poor prognosis in 115 patients with AF was 26.96%.Multivariate Logistic regression analysis showed that,New York Heart Association cardiac function grade≥III and elevated N-terminal pro-B-type natriuretic peptide(NT-proBNP),ROCK1,and HDAC3 were independent risk factors for poor prognosis in CHF patients with AF(P<0.05).ROC curve analysis showed that,the area under the curve of serum ROCK1 and HDAC3 levels combined prediction the poor prognosis of CHF patients with AF was 0.897,which was greater than that of single index prediction.Conclusion:The expression of serum ROCK1 and HDAC3 in CHF patients with AF were increased,which were closely relate to cardiac function and prognosis,the combination of serum ROCK1 and HDAC3 had a high value in predicting the poor prognosis of CHF patients with AF.