Relationship between serum Irisin,Metrnl,syndecan-1 and echocardiographic indices and prognosis in heart failure patients with intermediate ejection fraction
Song Yunping
Zhou Qingna
Wu Dan
Li Bin
Yu Xiang
Abstract：Objective To analyze the relationship between serum irisin,meteoric-like protein(Metrnl),and multili-gand proteoglycan-1(syndecan-1)and echocardiographic indexes and prognosis of patients with heart failure with interme-diate ejection fraction(HFmrEF).Relationship.Methods One hundred and thirty-two patients with HFmrEF who were hos-pitalized in the Department of Cardiovascular Medicine of Zhu Xianyi Memorial Hospital of Tianjin Medical University from October 2019 to March 2022 were selected as the HFmrEF group,and 102 volunteers who were healthy during the same pe-riod of physical examination were selected as the healthy control group.Serum Irisin,Metrnl,and syndecan-1 levels were detected and echocardiograms were examined in the 2 groups.Pearson's correlation analysis was performed to correlate ser-um Irisin,Metrnl,and syndecan-1 with echocardiographic indices of patients with HFmrEF;and patients with HFmrEF were followed up for 1 year after discharge.Multifactorial Cox proportional risk regression was used to analyze the influencing factors of poor prognosis in HFmrEF patients,and the value of Irisin,Metrnl,and syndecan-1 in predicting poor prognosis in HFmrEF patients was analyzed by the subject's work characteristics(ROC)curve.Results The serum Irisin and Metrnl levels,left ventricular ejection fraction(LVEF),mitral early diastolic filling velocity(E)/early diastolic mitral annular velocity(e')of the HFmrEF group were lower than those of the control group(t/P=-26.188/<0.001,-7.671/<0.001,-21.702/<0.001,-20.261/<0.001),syndecan-1 level,left ventricular end-diastolic internal diameter(LVEDD),and left ventricular end-systolic internal diameter(LVESD),LV end-diastolic posterior wall thickness(LVPWD)and end-diastolic septal wall thick-ness(IVSD)were higher than those in the control group(t/P=28.682/<0.001,10.067/<0.001,11.061/<0.001,17.371/<0.001,18.950/<0.001).Serum Irisin and Metrnl levels in HFmrEF patients were positively correlated with LVEF,E/e',and negatively correlated with LVEDD,LVESD,LVPWD,IVSD,(Irisin:r/P=0.326/<0.001,0.391/0.001,-0.301/0.003,-0.226/0.021,-0.358/<0.001,-0.423/<0.001,Metrnl:r/P=0.402/<0.001,0.374/<0.001;-0.277/0.007,-0.293/0.005,-0.315/<0.001,-0.338/<0.001);and syndecan-1 levels were negatively correlated with LVEF and E/e'and positively correlated with LVEDD and LVESD,LVPWD and IVSD(r/P=-0.427/<0.001,-0.385/<0.001,0.337/<0.001,0.275/0.008,0.308/0.002,0.265/0.012).Multi-factorial Coxproportional risk regression analysis showed that New York Heart Association(NYHA)cardiac function class IV,high levels of NT-proBNP,and high levels of syndecan-1 were risk factors for poor prognosis in patients with HFmrEF[HR(95%CI)=1.165(1.075-5.162),2.353(1.228-4.512),1.551(1.129-2.131)],and high levels of Irisin,high levels of Metrnl were protective factors[HR(95%CI)=0.505(0.312-0.819),0.583(0.374-0.911)].The area under the curve(AUC)of Irisin,Metrnl,and syndecan-1 for predicting poor prognosis in HFmrEF patients was 0.775,0.799,and 0.782,respectively,and the combined prediction AUC was 0.873,which was higher than the prediction of the indicators alone(Z=3.025,2.532,2.834,P<0.001,0.012,0.006).Conclusion The levels of serum Irisin and Metrnl in HFmrEF patients are decrease,and the level of syndecan-1 is increase,which is relate to cardiac dysfunction and poor prognosis.The combination of serum Irisin,Metrnl and syndecan-1 has a higher value in predicting the prognostic risk of HFmrEF patients.
Keywords：Heart failure with intermediate ejection fractionIrisinMetrnlsyndecan-1EchocardiographyPrognosis
Publication Date：2024-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 272-277 )