实时三维超声心动图联合血清 NT-proBNP、MR-proADM、sST2 对 心力衰竭患者诊断及预后的评估价值.

Objective: To investigate the value of real-time three-dimensional echocardiography (RT-3DE) combined with serum N-terminal pro-brain natriuretic peptide(NT-proBNP), mid-regional pro-adrenomedullin(MR-proADM) and soluble suppression of tumorigenicity 2 (sST2) in the diagnosis and prognosis of patients with heart failure (HF). Methods: 112 HF patients (HF group) admitted to Sunshine Union Hospital from March 2020 to October 2022 were selected, and another 50 volunteers (control group) who underwent physical examination during the same period were selected. All subjects underwent RT-3DE examination, and serum NT-proBNP, MR-proADM and sST2 levels were detected. RT-3DE parameters and serum NT-proBNP, MR-proADM, sST2 levels were compared between two groups. HF patients were followed up for 6 months after discharge, and the prognosis situation of patients were counted; patients were divided into poor prognosis group (37 cases) and good prognosis group (75 cases) according to the prognosis. The clinical value of RT-3DE parameters combined with serum NT-proBNP, MR-proADM and sST2 in the diagnosis of HF and the predictive value for poor prognosis were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic volume index (LVEDVI), end-systolic volume index (LVESVI), serum NT-proBNP, MR-proADM and sST2 in HF group were higher than those in control group (P<0.05), and left ventricular ejection fraction (LVEF) was lower than that in control group (P<0.05). The area under the curve (AUC) of RT-3DE parameters combined with serum NT-proBNP, MR-proADM and sST2 in the diagnosis of HF was 0.902, which was higher than that of each index alone. LVESV, LVEDV, LVEDVI, LVESVI, serum NT-proBNP, MR-proADM and sST2 levels in poor prognosis group were higher than those in good prognosis group (P<0.05), and LVEF was lower than that in good prognosis group (P<0.05). The AUC of RT-3DE parameters combined with NT-proBNP, MR-proADM and sST2 in predicting the poor prognosis of HF was 0.937, which was higher than that of each index alone. Conclusion: The levels of LVESV, LVEDV, LVEDVI, LVESVI, serum NT-proBNP, MR-proADM and sST2 increased and LVEF decreased in HF patients, RT-3DE parameters combined with serum NT-proBNP, MR-proADM and sST2 could improve the efficacy of HF diagnosis and prognosis prediction. [ABSTRACT FROM AUTHOR]