Predictive value of serum lipoprotein-associated phospholipase A2 level for ventricular remodeling in elderly patients with heart failure after sacubitril/valsartan treatment
Yin Yugang
Li Yao
Yang Chun
Lyu Lei
Abstract：Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)level for ventricular remodeling in elderly patients with heart failure(HF)after sacubitril/valsartan treatment.Methods A total of 102 patients with HF treated with sacubitril/valsartan in Eastern Theater General Hospital from January 2021 to December 2023 were selected as the research objects.According to the presence or absence of ventricular remodeling after treatment,the patients were divided into the occurrence group(34 cases)and the non-occurrence group(68 cases).The clinical data and electrocardiographic parameters were compared between the two groups.Excluding the confounding factors of collinearity,the independent correlation between each factor and ventricular remodeling was analyzed.The risk prediction model of ventricular remodeling was constructed and evaluated.The relationship between Lp-PLA2 and heart rate variability was analyzed by multiple linear regression.Hierarchical regression analysis was used to analyze the relationship between Lp-PLA2 and clinical parameters of ventricular remodeling.The dose-response relationship between Lp-PLA2 and ventricular remodeling was analyzed by restricted cubic spline.Results The confounding factors of collinearity were gradually excluded.Higher levels of N-terminal pro-brain natriuretic peptide,tumor necrosis factor-α,soluble suppression of tumorigenicity 2,high-sensitivity C-reactive protein,Lp-PLA2,transforming growth factor-β,matrix metalloproteinase 9,and carboxy-terminal peptide of type Ⅰ procollagen were found to be independently correlated with ventricular remodeling,as well as lower levels of standard deviation of R-R interval(all P＜0.05).The risk prediction model of ventricular remodeling was constructed,and the results of strong influence points(Cook distance＜1)and receiver operating characteristic curve analysis showed that the model had good prediction effect(area under the curve was 0.895).Multivariate linear regression analysis showed that Lp-PLA2 was an independent risk factor for predicting the reduc-tion of heart rate variability(β=-0.237,95％confidence interval:-0.468 to-0.127,P=0.031).The results of stratified analysis showed that Lp-PLA2 was significantly associated with ventricular remodeling in subgroups with different gender,age,body mass index,disease duration,etiology,and New York Heart Association cardiac function classification(all P＜0.05).The results of restricted cubic spline showed a non-linear dose-response relationship between Lp-PLA2 and ventricular remodeling(P＜0.05),and there were roughly significant positive correlations.Conclusion Lp-PLA2 is an independent risk factor for ventricular remodeling,which can effectively predict the occurrence of ventricular remodeling in patients with HF after treatment.
Keywords：Heart failureSacubitril/valsartanLipoprotein-associated phospholipase A2Ventricular remodeling
Publication Date：2025-03-07
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 331-336 )