外周血UCA1、FKN表达水平与慢性心力衰竭患者心功能、心室重构和预后的相关性OA

Objective To investigate the correlation of peripheral blood urothelial carcinoma antigen 1(UCA1)and fractalkine(FKN)expression levels with cardiac function,ventricular remodeling,and prognosis in patients with chronic heart failure(CHF).Methods A total of 129 CHF patients admitted to the Third Hospital of Shijiazhuang from January 2021 to January 2023 were selected and divided into grade Ⅱ(54 cases),grade Ⅲ(41 cases),and grade Ⅳ(34 cases)groups according to the New York Heart Association(NYHA)cardiac function classification.Cardiac function and ventricular remodeling indicators at admission were evaluated by echocardiography.Fasting peripheral blood samples were collected at 1 day,7 days,and 14 days after admission to detect UCA1 and FKN levels,observe their dynamic trends,and explore their associations with cardiac function,ventricular remodeling,and prognosis.Pearson correlation analysis was used to explore the correlation of peripheral blood UCA1 and FKN levels with cardiac function and ventricular remodeling indicators.Patients were followed up(until February 2024,with 2 cases lost to follow-up)and divided into a poor prognosis group(51 cases)and a good prognosis group(76 cases)based on readmission and all-cause death.The correlation of peripheral blood UCA1 and FKN with prognosis was evaluated by univariate and multivariate analyses,and the ROC curve was used to evaluate the predictive ability of peripheral blood UCA1 and FKN for poor prognosis.Results At 1 day and 7 days after admission,peripheral blood UCA1 mRNA and FKN levels in grade Ⅳ group were higher than those in grade Ⅲ and grade Ⅱ groups,and the levels in grade Ⅲ group were higher than those in grade Ⅱ group(all P<0.05).At 1 day and 7 days after admission,left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness at end-diastole(IVSD),left ventricular posterior wall thickness at end-diastole(LVPWD)and left ventricular mass index(LVMI)in grade Ⅳ group were higher than those in grade Ⅲ and grade Ⅱ groups,and those in grade Ⅲ group were higher than those in grade Ⅱ group(all P<0.05);left ventricular ejection fraction(LVEF)and left ventricular remodeling index(LVRI)in the grade Ⅳ group were lower than those in the grade Ⅲ and grade Ⅱ groups,and those in the grade Ⅲ group were lower than those in the grade Ⅱ group(all P<0.05).The expression levels of UCA1 and FKN in peripheral blood at 1 day and 7 days after admission were correlated with cardiac function and ventricular remodeling indicators(all P<0.05).NYHA cardiac function classification and UCA1 mRNA and FKN levels at 1 day and 7 days in the poor prognosis group showed statistically significant differences compared with the good prognosis group(χ2/t=7.148,14.994,13.450,14.800,11.027;all P<0.05).Logistic regression analysis showed that NYHA cardiac function classification(OR=1.883),UCA1 mRNA at 1 day(OR=2.195),UCA1 mRNA at 7 days(OR=1.944),FKN at 1 day(OR=1.946),and FKN at 7 days(OR=1.539)were risk factors for poor prognosis in CHF patients(all P<0.05).ROC curve analysis showed that the AUC values of UCA1 mRNA at 1 day and 7 days after admission for predicting the prognosis of CHF patients were 0.755(95%CI=0.618-0.892)and 0.809(95%CI=0.685-0.932),respectively;the AUC values of FKN at 1 day and 7 days after admission were 0.765(95%CI=0.633-0.898)and 0.812(95%CI=0.690-0.934),respectively.Conclusion Dynamic changes in UCA1 and FKN expression at different time points are closely related to the severity of CHF patients.Their early levels(at 1 day and 7 days after admission)have greater early warning value and can serve as dynamic monitoring indicators for poor prognosis in CHF patients.