超声心动图参数联合血清Ficolin-3、IGF-1对慢性心力衰竭患者预后不良的预测价值OA

Objective To investigate the predictive value of echocardiographic parameters[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LPWT),etc]combined with serum fibronectin-3(Ficolin-3)and insulin-like growth factor-1(IGF-1)for poor prognosis in patients with chronic heart failure(CHF).Methods A total of 128 patients with CHF admitted to the hospital from September 2022 to Septem-ber 2023 were selected as the study group.According to the New York Heart Association cardiac function classification criteria,the study group was divided into grade Ⅱ group(56 cases),grade Ⅲ group(44 cases),and grade Ⅳ group(28 cases).Another 130 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the control group.Baseline data of all subjects were collected.LVEDD,LVESD,LVEF,LPWT,etc were measured by echocardiography.The serum levels of Ficolin-3,IGF-1 in all study subjects and N-terminal B-type natriuretic peptide(NT-proBNP)in CHF patients were detected by enzyme-linked immunosorbent assay.According to the prognosis of CHF patients,all patients were divided into poor prognosis group and good prognosis group.Pearson correlation analysis was used to analyze the cor-relation between serum Ficolin-3 and IGF-1 levels and echocardiographic parameters of CHF patients.Multi-variate Logistic regression was used to analyze the influencing factors of poor prognosis in CHF patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of LVEDD,LVESD,LVEF,serum Ficolin-3 and IGF-1 alone and their combination for poor prognosis of CHF patients.Results The serum Ficolin-3 level of the study group was higher than that of the control group,and the ser-um IGF-1 level was lower than that of the control group,and the differences were statistically significant(P＜0.05).The level of serum Ficolin-3 in grade Ⅲ group and grade Ⅳ group was higher than that in grade Ⅱ group,and the level of IGF-1 was lower than that in grade Ⅱ group;the level of serum Ficolin-3 in grade Ⅳ group was higher than that in grade Ⅲ group,and the level of serum IGF-1 was lower than that in grade Ⅲ group,and the differences were statistically significant(P＜0.05).There were 51 cases in the poor prognosis group and 77 cases in the good prognosis group.The levels of LVEDD,LVESD,serum NT-proBNP and Fico-lin-3 in the poor prognosis group were higher than those in the good prognosis group,and the level of IGF-1 and LVEF were lower than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that serum Ficolin-3 levels in CHF patients were positively correlated with LVEDD and LVESD(P＜0.05),and negatively correlated with LVEF(P＜0.05).Serum IGF-1 level was negatively correlated with LVEDD and LVESD(P＜0.05),and positively correlated with LVEF(P＜0.05).Multivariate Logistic regression analysis showed that increased serum Ficolin-3 level and increased LVEDD and LVESD were independent risk factors for poor prognosis in CHF patients(P＜0.05).Increased serum IGF-1 level and increased LVEF were protective factors for poor prognosis in CHF patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of LVEDD,LVESD,LVEF,ser-um Ficolin-3 and IGF-1 levels alone and in combination to predict poor prognosis of CHF patients were 0.856,0.825,0.851,0.893,0.840 and 0.975,respectively.The AUC of combined prediction was greater than that of individual prediction(Z=4.223,4.367,3.974,3.470,4.231,P＜0.05).Conclusion Serum Ficolin-3 level is increased and IGF-1 level is decreased in CHF patients.Echocardiographic parameters combined with serum Ficolin-3 and IGF-1 levels have certain value in predicting poor prognosis of CHF patients,which can be used as a predictor of prognosis of CHF patients.