Relationship of chromogranin A and heat shock transcription factor 1 with cardiac injury in elderly patients with chronic heart failure
10.3969/j.issn.1009-0126.2024.06.005
- VernacularTitle:老年慢性心力衰竭患者嗜铬粒蛋白A和热休克转录因子1与心脏损伤的关系
- Author:
Yan MA
1
;
Liying SHI
;
Haixiong WANG
;
Liping GUO
Author Information
1. 030027 太原市中心医院(北京大学第一医院太原医院)全科医学科
- Keywords:
heart failure;
chromogranin A;
heat shock transcription factors;
ventricular remode-ling;
myocardial injury
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(6):619-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship of changes in serum chromogranin A(CgA)and heat shock transcription factor 1(HSF1)levels with cardiac remodeling and myocardial injury in elderly patients with chronic heart failure(CHF).Methods A total of 165 elderly CHF patients admitted to our hospital from January 2019 to May 2022 were selected as the disease group,and according to NYHA classification,they were divided into Class Ⅰ(28 patients),Ⅱ(29 patients),Ⅲ(65 patients)and Ⅳ(43 patients)subgroups.Another 80 healthy individuals taking physical examination in our hospital during the same period were enrolled as the control group.The serum CgA and HSF1 levels were detected,and the indicators of cardiac remodeling and myo-cardial injury were collected at admission in the two groups.The correlation of serum CgA and HSF1 levels with cardiac remodeling and myocardial injury was determined with Pearson correla-tion analysis.During 1 year's follow-up,6 cases were lost,and the left 159 patients were divided into MACE group(51 cases)and non-MACE group(108 cases)according to whether MACE occurred.Univariate and multivariate logistic regression analyses were used to analyze the influen-cing factors of MACE,and ROC curve was plotted to analyze the predictive value of serum CgA and HSF1 levels for MACE.Results The disease group had significantly higher left ventricular mass index(LVMI),left ventricular end-systolic volume(LVESV),left ventricular posterior wall thickness(LVPWT),serum levels of CgA,cardiac troponin Ⅰ(cTnⅠ),creatine kinase isoenzyme(CK-MB)and N-terminal B-type natriuretic peptide precursor(NT-proBNP),and obviously lower HSF1 level and left ventricular ejection fraction(LVEF)when compared with the control group(P＜0.01).Pearson correlation analysis showed that serum CgA level was negatively correlated with LVEF and positively with LVMI,LVESV,LVPWT,and serum levels of cTnⅠ,CK-MB and NT-proBNP(P＜0.01);serum HSF1 level was positively correlated with LVEF and negatively with LVMI,LVESV,LVPWT,and serum cTnⅠ,CK-MB and NT-proBNP levels(P＜0.01).Multi-variate logistic regression analysis showed that CgA,HSF1,LVEF,LVMI,LVESV,LVPWT and cTnⅠ were influencing factors for MACE in elderly CHF patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the cut-off value of CgA was 387.55 μg/L,the sensitivity was 74.51％,the specificity was 71.30％,and the AUC value was 0.802(95％CI:0.751-0.855);the cut-off value of HSF1 was 2.34 ng/L,the sensitivity was 74.51％,the specificity was 69.44％,and the AUC value was 0.760(95％CI:0.707-0.812).Conclusion In elderly CHF patients,serum levels of CgA and HSF1 are closely associated with cardiac remodeling and myocardial injury,and the two indicators can be used as prognostic indicators for MACE.
