Diagnostic value of ET-1,Apelin combined with ECG for hypertrophic cardiomyopathy and their as-sociation with prognosis
10.3969/j.issn.1008-0074.2025.02.14
- VernacularTitle:ET-1、Apelin联合心电图检测对肥厚型心肌病的诊断价值及与预后的关系
- Author:
Yu-yue SHEN
1
;
Geng-xin SUN
1
;
Xia-li WANG
1
;
Xi-hui WANG
1
Author Information
1. 西安医学院第二附属医院心内科,陕西西安 710000
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy,hypertrophic;
Endothelin-1;
Adipokines;
Electrocardiography
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2025;34(2):205-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate levels of endothelin-1(ET-1)and Apclin in patients with hypertrophic car-diomyopathy(HCM)and diagnostic value of their combination with ECG for HCM,and their association with prognosis.Methods:A total of 150 HCM patients admitted in the Second Affiliated Hospital of Xi'an Medical Uni-versity between June 2020 and June 2022 were selected as observation group.According to death during follow-up,the observation group was divided into survival group(n=64)and death group(n=86),and another 100 healthy volunteers who underwent physical examination in our hospital simultaneously were selected as control group.ET-1,Apelin and ECG indexes were compared between above-mentioned groups.Diagnostic value of ET-1,Apelin and ECG combined detection for HCM was analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regression was used to analyze influencing factors of death within 6-month follow-up in HCM patients,and nomogram model was established.Results:Compared with participants in control group,those in the observa-tion group had significant higher ET-1[(0.64±0.15)pmol/L vs.(0.39±0.07)pmol/L],QRS wave group(∑QRS)[(23.60±3.96)mm vs.(14.02±1.78)mm],Cornell voltage index(SV3+RaVL)[(2.12±0.40)mV vs.(1.05±0.20)mV]and S-wave on V1 lead+R-wave on V5 lead(SV1+RV5)[(3.88±0.73)mV vs.(2.24±0.34)mV],and significant lower Apelin[(1.10±0.25)pg/ml vs.(1.58±0.17)pg/ml]level(P＜0.001 all).ROC curve indicated that the area under the curve(AUC)of combined detection of above five indexes diagno-sing HCM was 0.933(95％CI 0.895～0.961),significantly higher than any single detection(Z=3.681～6.428,P＜0.001 all),the H-L goodness of fit test showed P=0.056,suggesting that the model was well accepted,and DCA showed that ET-1 and Apelin combined ECG detection model had good clinical application value in HCM.Multivariate Logistic regression indicated that ET-1,∑QRS,SV3+RaV and SV1+RV5 were independent risk factors for death within 6-month in HCM patients(OR=2.617～3.600,P＜0.001 all),and Apelin was its inde-pendent protective factor(OR=0.271,P＜0.001).The nomogram model of HCM patients dying within 6 months was 4.627+0.452 × ET-1+0.536 × Apelin+0.575 × ∑QRS+0.541 × SV3+RaVL+0.352 × SV1+RV5.Conclusion:Serum ET-1 and Apelin levels significantly change in HCM patients,and the combination of ECG detection and both indexes have good performance diagnosing HCM and are independent influential factors for the death of HCM patients within 6 months.
