慢性心力衰竭患者NT-proBNP、CRP/Hb、GDF-15改变率与抗心力衰竭治疗后心脏多普勒超声参数改变率的相关性OA

Objective To investigate the correlation between the change rates of N-terminal B-type natriuretic peptide(NT-proBNP),C-reactive protein/hemoglobin(CRP/Hb),growth differentiation factor-15(GDF-15)and the changes of cardiac Doppler ultrasound parameters in patients with chronic heart failure(CHF)after anti-heart failure treatment.Methods A total of 172 patients with CHF admitted from October 2022 to March 2024 were selected.All patients received conventional anti-heart failure treatment.According to the improvement of New York Heart Association(NYHA)functional classification,the efficacy was evaluated and they were divided into effective treatment group and ineffective treatment group.The levels of NT-proBNP,CRP/Hb,GDF-15,cardiac Doppler ultrasound parameters[left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPW),left ventricular end-diastolic diameter(LVEDd),interventricular septum thickness(IVS),heart failure echocardiography index(HFEI)]and change rates were compared between the two groups before and after anti-heart failure treatment.The correlation between the change rate of NT-proBNP,CRP/Hb,GDF-15 and the change rate of cardiac Doppler ultrasound parameters was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive effect of change rates of NT-proBNP,CRP/Hb and GDF-15 on the short-term efficacy of heart failure.Results After anti-heart failure treatment,91 patients showed marked improvement,43 patients showed improvement,and 38 patients showed no improvement.Patients with marked improvement and improvement were included in the effective treatment group(n=134),while those with no improvement were included in the ineffective treatment group(n=38).At 4 weeks after treatment,the levels of NT-proBNP,CRP/Hb and GDF-15 in the effective treatment group were lower than those in the ineffective treatment group,while the change rates of NT-proBNP,CRP/Hb and GDF-15 were higher than those in the ineffective treatment group(P＜0.01).At 4 weeks after treatment,LVEF in the effective treatment group was higher than that in the ineffective treatment group,LVPW,LVEDd,IVS and HFEI were lower than those in the ineffective treatment group,and the change rates of LVEF,LVPW,LVEDd,IVS and HFEI were higher than those in the ineffective treatment group(P＜0.01).At 4 weeks after anti-heart failure treatment,the change rates of NT-proBNP,CRP/Hb and GDF-15 were positively correlated with the change rates of LVEF,LVPW,LVEDd,IVS and HFEI(P＜0.01).The area under the curve of change rates of NT-proBNP,CRP/Hb,and GDF-15 in combination to predict the short-term efficacy of anti-heart failure treatment in CHF patients was 0.916(95％CI:0.864,0.953),with a sensitivity of 81.58％and a specificity of 90.30％.Conclusion The change rate of NT-proBNP,CRP/Hb and GDF-15 in CHF patients after anti-heart failure treatment are significantly correlated with the changes of LVEF,LVPW,LVEDd,IVS and HFEI.Monitoring the change rate of NT-proBNP,CRP/Hb and GDF-15 has a high predictive efficiency for the short-term efficacy of anti-heart failure treatment in CHF patients.