关键词: 组织蛋白酶K, 解聚蛋白样金属蛋白酶-7, 心室重构, 慢性心力衰竭, 预后

Abstract:

Objective To investigate the relationship between serum cathepsin K（Cat-K） and a disintegrin and metalloproteinase with thrombospondin motifs 7（ADAMTS-7） with ventricular remodeling and prognosis in chronic heart failure（CHF） patients. Methods Totally，195 patients with CHF（CHF group） and 101 healthy subjects（control group） were enrolled from Handan Central Hospital from February 2018 to June 2020. The general data of CHF patients were collected. Random blood glucose，glycated hemoglobin A_1c（HbA_1c），N-terminal pro-B-type natriuretic peptide（NT-proBNP），B-type natriuretic peptide（BNP），Cat-K and ADAMTS-7 levels and left ventricular ejection fraction（LVEF），ventricular remodeling parameters [left ventricular end-diastolic diameter（LVEDD），left ventricular posterior wall thickness（LVPWT），interventricular septum thickness（IVST）] were determined，and left ventricular mass index（LVMI） was calculated. According to New York Heart Association（NYHA） classification，the CHF group was classified into Grade Ⅱ group（65 cases），Grade Ⅲ group（82 cases） and Grade Ⅳ group（48 cases）. Pearson correlation analysis was used to evaluate the correlation among the indicators. Logisitc regression analysis was used to evaluate the risk factors for poor prognosis in CHF patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each indicator in determining poor prognosis in patients with CHF. Results Serum Cat-K and ADAMTS-7 in CHF group were higher than those in control group（P<0.05）. Serum Cat-K，ADAMTS-7，BNP，NT-proBNP，LVEDD，LVPWT，IVST and LVMI in NYHA Grade Ⅳ group were higher than those in NYHA Grade Ⅲ group and NYHA Grade Ⅱ group（P<0.05）. LVEF was lower than those of NYHA Grade Ⅲ group and NYHA Grade Ⅱ group（P<0.05）. Pearson correlation analysis showed that Cat-K and ADAMTS-7 were positively correlated with BNP，NT-proBNP，LVEDD，LVPWT，IVST and LVMI（P<0.05），and they were negatively correlated with LVEF（P<0.05）. Logistic regression analysis showed that the increasing of NT-proBNP，NYHA grade，Cat-K and ADAMTS-7 and the decreasing of LVEF were risk factors for poor prognosis in CHF patients [odds ratio（OR）=1.057，1.772，1.075，1.335 and 0.903，95% confidence intervals（CI） were 1.003-1.113，1.159-2.709，1.034-1.116，1.091-1.634 and 0.819-0.996，respectively]. The area under curve （AUC） of NT-proBNP，LVEF，NYHA grade，Cat-K and ADAMTS-7 in determining poor prognosis of CHF patients were 0.729，0.704，0.803，0.720，0.688 and 0.886，respectively. Conclusions Serum Cat-K and ADAMTS-7 are correlated with ventricular remodeling and poor prognosis in CHF patients.

Key words: Cathepsin K, A disintegrin and metalloproteinase with thrombospondin motifs 7, Ventricular remodeling, Chronic heart failure, Prognosis