Correlation among mid-regional pro-adrenomedullin,desmosine,heart function and short-term prognosis in patients with heart failure with midrange ejection fraction
Zhang Ye
Fang Zhengya
Zhu Suwen
Shen Yueyun
Xie Pengcheng
Liu Yingchun
Wang Hongju
Abstract：Objective To discuss the relationship among mid-regional pro-adrenomedullin(MR-proADM),desmosine(DES),heart function and short-term prognosis in patients with heart failure with midrange ejection fraction(HFmrEF).Methods HFmrEF patients(n=124)were selected and divided,according to NYHA grades,into grade Ⅱ group(n=32),grade Ⅲ group(n=45)and grade Ⅳ group(n=47)in People's Hospital of Liyang City from June 2020 to June 2022.The levels of serum MRpro-ADM and DES were detected by using enzyme-linked immunosorbent assay(ELISA).Based on the occurrence of cardiovascular death/rehospitalization due to heart failure during 6-month follow-up period,HFmrEF patients were divided into poor prognosis group(n=26)and good prognosis group(n=98).The relationship among MRpro-ADM,DES,heart function and short-term prognosis was analyzed by using Spearman correlation analysis in HFmrEF patients.The predictive value of MR-proADM and DES to short-term prognosis was analyzed by using ROC curve.The influencing factors of short-term prognosis were analyzed by using multi-factor Logistic regression analysis.Results With the increase of heart function grades,levels of serum MR-proADM and DES gradually increased(grade Ⅳgroup>grade Ⅲ group>grade Ⅱ group,P<0.05).The levels of MRpro-ADM and DES were positively correlated to heart function grades(r=0.609、r=0.542,P<0.001),and they were lower in good prognosis group than those in poor prognosis group(P<0.05).In predicting short-term prognosis,AUC of MRpro-ADM was 0.778(95％CI:0.733～0.823),AUC of DES was 0.863(95％CI:0.818～0.908),and AUC of combination of MRpro-ADM and DES was 0.931(95％CI:0.881～0.976).The percentage of hypertension cases and level of brain natriuretic peptide(BNP)were lower in good prognosis group than those in poor prognosis group(P<0.05).The results of multi-factor Logistic regression analysis showed that complicated hypertension(OR=2.368,95％CI:1.465～3.827),BNP≥408.12 pg/ml(OR=2.649,95％CI:1.563～4.487),MRpro-ADM≥0.89 nmol/L(OR=2.754,95％CI:1.684～4.504)and DES≥19.09 ng/ml(OR=3.089,95％CI:1.841～5.183)were risk factors of poor short-term prognosis in HFmrEF patients(P<0.05).Conclusion The levels of MRpro-ADM and DES show higher expressions in HFmrEF patients with poor short-term prognosis,and related to heart function grades,and they can be used as potential markers for reviewing short-term prognosis in HFmrEF patients.
Keywords：Mid-regional pro-adrenomedullinDesmosineHeart failure with midrange ejection fractionHeart functionPrognosis
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 452-456 )