缺血性心力衰竭患者血清miR-9-5p、miR-185-5p表达与心功能及心室重构的关系

Relationship between serum miR-9-5p,miR-185-5p expressions and cardiac function and ventricular remodeling in patients with ischemic heart failure

目的探讨缺血性心力衰竭(IHF)患者血清miR-9-5p和miR-185-5p表达与心功能和心室重构的关系。方法选取2021年2月—2023年2月南阳市中心医院IHF患者108例(IHF组),参照美国纽约心脏病协会(NYHA)心功能分级标准将IHF患者分为Ⅰ~Ⅱ级组(35例)、Ⅲ级组(42例)和Ⅳ级组(31例)。另选取同期南阳市中心医院轻度冠心病缓解期且无心力衰竭的患者50例作为疾病对照组。收集所有研究对象的一般资料和实验室常规生化项目检测结果,并检测血清miR-9-5p、miR-185-5p、B型钠尿肽(BNP)、左室射血分数(LVEF)、左室前后径(LAD)和左室舒张末期内径(LVEDD)。采用Pearson相关分析评估血清miR-9-5p、miR-185-5p与心功能和心室重构的相关性。采用受试者工作特征(ROC)曲线评价血清miR-9-5p、miR-185-5p诊断IHF的效能。结果IHF组血清miR-9-5p、miR-185-5p相对表达量和BNP、LAD、LVEDD均显著高于疾病对照组(P<0.05),LVEF显著低于疾病对照组(P<0.05)。Ⅰ~Ⅱ级组、Ⅲ级组、Ⅳ级组血清miR-9-5p、miR-185-5p相对表达量和LAD、LVEDD、BNP均依次升高(P<0.001),LVEF依次降低(P<0.001)。血清miR-9-5p、miR-185-5p水平与LAD、LVEDD、BNP均呈正相关(P<0.05),与LVEF均呈负相关(P<0.05)。miR-9-5p、miR-185-5p均为IHF发生的危险因素[比值比(OR)值分别为2.114、2.224,95%可信区间(CI)分别为1.129~3.958、1.297~3.813,P<0.05]。miR-9-5p、miR-185-5p、LVEF、BNP单项检测诊断IHF的AUC分别为0.806、0.789、0.734、0.751;miR-9-5p+miR-185-5p+LVEF、miR-9-5p+miR-185-5p+BNP和4项指标联合检测的AUC分别为0.879、0.876、0.936。结论IHF患者血清miR-9-5p、miR-185-5p表达升高,且与心功能损伤程度有关,可能参与了心室重构过程。血清miR-9-5p、miR-185-5p、BNP和LVEF联合检测对IHF有较高的诊断效能。

Objective To investigate the relationship between the expressions of serum miR-9-5p and miR-185-5p in patients with ischemic heart failure(IHF)and cardiac function and ventricular remodeling.Methods From February 2021 to February 2023,108 patients with IHF who received treatment at Nanyang Central Hospital were enrolled.According to New York Heart Association(NYHA)cardiac function classification,the patients with IHF were classified into gradeⅠ-Ⅱgroup(35 cases),gradeⅢgroup(42 cases)and gradeⅣgroup(31 cases).In addition,50 patients with mild coronary heart disease in remission period without heart failure were randomly enrolled as control group.The levels of serum miR-9-5p,miR-185-5p,B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left atrial diameter(LAD)and left ventricular end diastolic diameter(LVEDD)were determined and measured.Pearson correlation analysis was used to evaluate the correlation of serum miR-9-5p,miR-185-5p and cardiac function,ventricular remodeling.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of serum miR-9-5p,miR-185-5p for the diagnosis of IHF.Results The miR-9-5p and miR-185-5p relative expressions,LAD,LVEDD and BNP in IHF group were higher than those in control group(P<0.05),and LVEF was lower than that in control group(P<0.05).The levels of LAD,LVEDD,BNP,miR-9-5p and miR-185-5p relative expressions were increased in gradeⅠ-Ⅱ,Ⅲ,Ⅳgroups(P<0.001),and LVEF was decreased(P<0.001).LAD,LVEDD,BNP and miR-9-5p,miR-185-5p had positive correlation(P<0.05).LVEF had negative correlation(P<0.05).The miR-9-5p and miR-185-5p were risk factors for IHF[odds ratios(OR)were 2.114 and 2.224,95%confidence intervals(CI)were 1.129-3.958 and 1.297-3.813,P<0.05].The areas under curves(AUC)of miR-9-5p,miR-185-5p,LVEF,BNP were 0.806,0.789,0.734 and 0.751,respectively.The AUC of miR-9-5p+miR-185-5p+LVEF,miR-9-5p+miR-185-5p+BNP,miR-9-5p+miR-185-5p+LVEF+BNP were 0.879,0.876,0.936,respectively.Conclusions The expression levels of miR-9-5p and miR-185-5p in serum of patients with IHF are increased,they are related to cardiac dysfunction and may be involved in ventricular remodeling.The combination of serum miR-9-5p,miR-185-5p,LVEF and BNP has high efficacy in the diagnosis of IHF.