Abnormal expression of IGFBP7 and CaN predicts left atrial fibrosis and deformable function in heart failure patients with preserved ejection fraction and atrial fibrillations
DA Ying-xiao
DI Ning-ning
ZHOU Song
CUI Zhen-chuan
HUANG Ling-fang
Abstract：Objective To investigate the predictive value of abnormal expression of IGFBP7 and CaN for left atrial fibrosis and deformable function in patients with heart failure with preserved ejection(HFpEF)and atrial fibrillation(AF).Methods 180 patients with HFpEF admitted to our hospital were selected and divided into the simple HFpEF group(n=94)and the combined group(n=86)according to whether they were complicated with AF.At the same time,80 healthy people were selected as the control group.The degree of left atrial fibrosis and left atrial deformable function,insulin-like growth factor binding protein 7(IGFBP7)and calcineurin(CaN)levels were compared among the three groups.Multivariate logistic regression analysis was used to analyze the risk factors for HFpEF complicated with AF.Spearman correlation analysis was used to analyze the correlation between serum IGFBP7 and CaN levels and left atrial fibrosis and left atrial deformable function.Receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of IGFBP7 and CaN levels for HFpEF with AF.Results The LAS-a,LAS-s and LATEF of HFpEF patients were significantly lower than the control group[(35.02±4.03)vs.(38.86±3.89),(15.03±2.31)vs.(18.74±2.96),(41.87±9.46)vs.(51.98±9.87),P<0.05],and all above in the combined group were significantly lower than the HFpEF group[(44.72±6.02)vs.(40.68±5.89),(11.32±2.46)vs.(10.09±1.87),(28.67±5.01)vs.(24.86±4.78),(0.45±0.06)vs.(0.42±0.08),P<0.05].LAD,E/e′,LAVI,and Tei index of HFpEF patients were significantly higher than the control group[(40.68±5.89)vs.(33.72±4.52),(10.09±1.87)vs.(7.62±1.45),(24.86±4.78)vs.(21.32±4.04),(24.86±4.78)vs.(21.32±4.04),(0.42±0.08)vs.(0.38±0.08),P<0.05],and all above in the combined group were significantly higher than the HFpEF group(44.72±6.02)vs.(40.68±5.89),(11.32±2.46)vs.(10.09±1.87),(28.67±5.01)vs.(24.86±4.78),(0.45±0.06)vs.(0.42±0.08),P<0.05].The levels of IGFBP7 and CaN in HFpEF patients were significantly higher than the control group(P<0.05),and both above in the combined group was significantly higher than the HFpEF group(P<0.05).The results of multivariate logistic regression analysis showed that IGFBP7,CaN,LAS-a,LAS-s,LAD,E/e′,LAVI,Tei index and age were the risk factors for HFpEF with AF(P<0.05).Spearman correlation analysis showed that IGFBP7 and CaN levels were negatively correlated with LAS-a,LAS-s and LATEF(r=-0.512,-0.486;-0.508,-0.423;-0.326,-0.428;P<0.05),but positively correlated with LAD,E/e′,LAVI,Tei index and age(r=0.328,0.289;0.218,0.321;0.238,0.264;0.208,0.142;0.482,0.358;P<0.05).ROC curve analysis showed that the area under the curve of IGFBP7 and CaN for predicting HFpEF with AF was 0.903 and 0.999(P<0.001),the optimal cut-off point was 24.04 ng/mL and 0.42 ng/mL,the sensitivity was 82.6%and 98.8%,and the specificity was 87.2%and 99.7%,respectively.Conclusion The abnormal expression of IGFBP7 and CaN may be related to left atrial fibrosis and deformable function in HFpEF patients with AF,and they can be used as the predictors of HFpEF with AF.
Keywords：Heart failure with preserved ejectionAtrial fibrillationInsulin-like growth factor binding protein 7CalcineurinLeft atrial
Publication Date：2024-05-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 422-427 )