Abstract:

Objective To evaluate the prognosis of patients with acute decompensated heart failure （ADHF） by the combination of serum cholinesterase，galectin-3 and cardiac function indicators. Methods From August 2020 to August 2022，133 patients with ADHF at West China Hospital of Sichuan University and Beijing Haidian Hospital were enrolled. The 3-month and 1-year post-treatment periods were set as time points for short-term and long-term prognosis assessment. The patients were classified into poor short-term prognosis group，poor long-term prognosis group and good prognosis group. The differences of serum cholinesterase，galectin-3，N-terminal B-type natriuretic peptide （NT-proBNP），cardiac troponin I（cTnI）and left ventricular ejection fraction（LVEF）were compared. Multivariate Logistic regression analysis was used to evaluate the risk factors for poor short-term prognosis and poor long-term prognosis of the patients. Receiver operating characteristic（ROC）curve was used to analyze the role of combined determination of serum cholinesterase，galectin-3，NT-proBNP，cTnI and LVEF in predicting poor short-term and long-term prognosis in patients with ADHF. Results The serum cholinesterase levels and LVEF in short-term poor prognosis group and long-term poor prognosis group were both lower than those in good prognosis group（P<0.001），while the levels of galectin-3，NT-proBNP and cTnI were all higher than those in good prognosis group （P<0.001）. Renal function insufficiency，liver function insufficiency and acute coronary syndrome were independent risk factors for poor short-term prognosis（P<0.01），while renal function insufficiency and liver function insufficiency were independent risk factors for poor long-term prognosis（P<0.05）. Decreased serum cholinesterase，decreased LVEF，elevated galectin-3，elevated NT-proBNP and elevated cTnI were independent risk factors for poor short-term prognosis and poor long-term prognosis，respectively（P<0.05）. The areas under curves（AUC） for the single determinations of serum cholinesterase and galectin-3 in predicting poor short-term prognosis of patients with ADHF was 0.858 and 0.752，respectively，while the AUC for predicting poor long-term prognosis were 0.693 and 0.690，respectively. The AUC for the combined determination of serum cholinesterase，galectin-3，NT-proBNP，cTnI and LVEF in predicting poor short-term and long-term prognosis were 0.909 and 0.869，respectively. Conclusions The determination of serum cholinesterase，galectin-3，NT-proBNP，cTnI and LVEF is helpful for predicting the poor short-term and long-term prognosis of patients. The combined determination has a higher predictive value and a higher evaluation value for short-term prognosis than long-term prognosis.

Key words: Cholinesterase, Galectin-3, Acute decompensated heart failure, Prognosis