基于血清MFAP4、FBN1、TFAM水平探讨芪苈强心胶囊辅治慢性心力衰竭的疗效及机制OA

Objective To investigate the effects of Qili Qiangxin Capsule combined with standardized Western medi-cine treatment on cardiac function and serum levels of microfibrillar-associated protein 4(MFAP4),fibrillin-1(FBN1),and mi-tochondrial transcription factor A(TFAM)in patients with chronic heart failure(CHF),and to preliminarily explore its poten-tial mechanism of action.Methods A total of 120 patients with CHF treated in the Department of Cardiology,Xingtai Cen-tral Hospital,from January 2022 to December 2023 were enrolled and randomly assigned into a control group and an observa-tion group,with 60 cases in each group.Both groups received standardized Western medicine treatment.The observation group was additionally given Qili Qiangxin Capsules.The treatment duration for both groups was 12 weeks.The changes in tradition-al Chinese medicine(TCM)syndrome scores,clinical efficacy based on improvement in New York Heart Association(NYHA)functional class,6-minute walking distance(6MWD),left ventricular ejection fraction(LVEF),N-terminal pro-B-type natri-uretic peptide(NT-proBNP),serum MFAP4,FBN1,TFAM levels,and safety indexes were compared between the two groups before and after treatment.Pearson correlation analysis was performed to evaluate the correlations between biomarkers and car-diac function indexes.Results After 12 weeks of treatment,the overall distribution of clinical efficacy was superior in the observation group compared with the control group(U=1276.000,P=0.003),and the total effective rate was also higher in the observation group than in the control group(93.33%vs.76.67%,χ2=6.536,P=0.011).In both groups,TCM syndrome scores decreased and 6MWD increased after treatment,with greater improvement in the observation group than in the control group(t/P=3.514/<0.001 and 2.522/0.013,respectively).LVEF increased and NT-proBNP levels decreased in both groups after treatment,with more pronounced changes in the observation group(t/P=4.329/<0.001 and-8.497/<0.001,respectively).Serum MFAP4 and FBN1 levels decreased,whereas TFAM levels increased in both groups after treatment,and the magnitude of change was greater in the observation group(t/P=7.591/<0.001,9.602/<0.001,and 8.393/<0.001,respectively).Pearson correlation analysis showed that MFAP4 was positively correlated with NT-proBNP and negatively correlated with LVEF(r/P=0.691/<0.001 and-0.460/<0.001,respectively);FBN1 was positively correlated with NT-proBNP and negatively correlated with LVEF(r/P=0.572/<0.001 and-0.646/<0.001,respectively);and TFAM was positively correlated with LVEF and nega-tively correlated with NT-proBNP(r/P=0.538/<0.001 and-0.517/<0.001,respectively).No statistically significant differences were found in alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),or estimated glomeru-lar filtration rate(eGFR)between the two groups before and after treatment(all P>0.05).Conclusion On the basis of stand-ardized Western medicine treatment,Qili Qiangxin Capsule can further improve cardiac function and clinical symptoms in pa-tients with CHF.Its therapeutic effects may be related to downregulation of MFAP4 and FBN1,which are associated with my-ocardial fibrosis,and upregulation of TFAM,which is related to mitochondrial function.