sST2联合H2FPEF评分在射血分数保留心力衰竭患者中的预后价值

Prognostic value of serum sST2 level combined with H2FPEF score in heart failure with preserved ejection fraction patients

关键词:  sST2  H2FPEF评分  射血分数保留心力衰竭  不良心血管事件

Key words:  sST2  H2FPEF score  heart failure with preserved ejection fraction  adverse cardiovascular events

摘要:

目的探讨可溶性肿瘤发生抑制蛋白2（soluble tumorigenesis suppressor protein 2， sST2）联合H2FPEF评分对于射血分数保留心力衰竭（heart failure with preserved ejection fraction， HFpEF）患者的预后价值。方法选取2019年12月—2020年12月在同济大学附属杨浦医院接受治疗的HFpEF患者162例，另选同期82例无心力衰竭（heart failure, HF）患者作为对照组。测定患者sST2、B型利钠肽（BNP）及H2FPEF评分。所有受检者均出院后随访1年，记录包括全因死亡、心血管病死亡、HF再住院等主要不良心血管事件（major adverse cardiovascular events, MACE）发生情况。结果HFpEF组sST2、BNP、左房容积指数（left atrial volume index, LAVI）、H2FPEF评分明显高于对照组，且sST2与其有一定相关性。sST2、BNP、H2FPEF评分对于HFpEF患者1年MACE预测的ROC曲线下面积（AUC）分别为0.861、0.785、0.742（P＜0.001）。sST2＞28ng/mL和H2FPEF评分＞3者MACE发生率明显高于其他患者（P＜0.05），两项均高者有更高的MACE发生率（P＜0.001）。结论sST2与H2FPEF评分可用于HFpEF患者的预后评价，sST2联合H2FPEF评分对HFpEF患者1年MACE发生率具有良好的预测价值。

Abstract:

ObjectiveTo investigate the prognostic value of soluble tumorigenesis suppressor protein 2(sST2) level combined with H2FPEF score in heart failure with preserved ejection fraction(HFpEF) patients. MethodsOne hundred and sixty-two patients with HFpEF treated in Yangpu Hospital affiliated to Tongji University School of Medicine from December 2019 to December 2020 were enrolled, and 82 patients without heart failure treated during the same period were selected as controls. The serum levels of sST2, B-type natriuretic peptide(BNP) were measured and H2FPEF score was evaluated. All subjects were followed up for 1 year after discharge, the occurrence of major adverse cardiovascular events(MACE), including all-cause death, cardiovascular disease death and rehospitalization of heart failure was documented. ResultsSerum levels of sST2 and BNP, left atrial volume index (LAVI) and H2FPEF scores in HFpEF group were significantly higher than those in the control group, and there were correlations of sST2 with BNP level, LAVI and H2FPEF（all P<0.05） in HFpEF group. The area under ROC curve(AUC) of sST2, BNP and H2FPEF score for predicting 1-year MACE in patients with HFpEF were 0.861, 0.785 and 0.742, respectively(P<0.001). The incidence of MACE in patients with sST2＞28ng/mL and H2FPEF score＞3 was significantly higher than that in other patients(P<0.05), and the MACE rate was even higher in patients with both higher indicators(P<0.001). ConclusionThe serum sST2 level and H2FPEF score can be used to evaluate the prognosis of HFpEF patients，and the combination of both has a better predictive value for 1-year MACE incidence in HFpEF patients.