急性心肌梗死患者血清lncRNA GAS5水平与左室重构的相关性

Relationship between circulating lncRNA GAS5 level and left ventricular remodeling in patients with acute myocardial infarction

摘要:

目的 探究心肌梗死患者血清长链非编码RNA（lncRNA）GAS5水平与左室重构（LVR）的关系。方法 选取2018年4月—2019年4月在天津市泰达医院接受治疗的169例急性心肌梗死患者作为研究对象，根据是否发生LVR分为LVR组62例与非LVR组107例。采用实时荧光定量聚合酶链反应检测血液lncRNA GAS5相对表达量，超声检测左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左室射血分数（LVEF）及左室重构指数（LVRI）。采用Pearson法分析lncRNA GAS5与左心室指标的相关性，Logistic回归分析lncRNA GAS5与急性心肌梗死心室重构的关系，ROC曲线分析lncRNA GAS5对急性心肌梗死患者LVR的预测价值。结果 LVR组甘油三酯（TG）、LVEDV及LVESV高于非LVR组（P <0.05）；而LVEF、LVRI低于非LVR组（P <0.05）。LVR组lncRNA GAS5较非LVR组降低（P <0.05）。lncRNA GAS5与LVEDV、LVESV呈负相关（r =-0.324和0.458，P =0.000和0.001），与LVEF、LVRI呈正相关（r =0.376和0.395，均P =0.000）。LVEF［O=3.152（95% CI：1.651，6.016）］、LVRI［O=1.354（95% CI：1.137，1.614）］及lncRNA GAS5［O=1.265（95% CI：1.346，1.189）］是影响急性心肌梗死者发生LVR的危险因素。lncRNA GAS5诊断急性心肌梗死患者LVR的临界值为0.812，AUC为0.827（95% CI：0.768，0.891），敏感性为71.56%（95% CI：0.603，0.788），特异性为82.66%（95% CI：0.742，0.923）。结论 急性心肌梗患者血清lncRNA GAS5水平降低与LVR的发生有关，在心室重构诊断中具有一定的临床价值。

Abstract:

Objective To investigate the relationship between serum level of long non-coding RNA (lncRNA) growth arrest specific 5 (GAS5) and left ventricular remodeling (LVR) in patients with acute myocardial infarction.Methods A total of 169 patients with acute myocardial infarction were divided into LVR group (n = 62) and non-LVR group (n = 107) according to whether LVR occurred or not. The expression of lncRNA GAS5 in blood was detected by real-time quantitative polymerase chain reaction, and left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular remodeling index (LVRI) were measured by echocardiography. Pearson correlation analysis was used to determine the correlation between lncRNA GAS5 and indices for left ventricular function. Logistic regression analysis was performed to explore the relationship between lncRNA GAS5 and ventricular remodeling in acute myocardial infarction. Besides, receiver operating characteristic (ROC) curve was used to analyze the predictive value of lncRNA GAS5 for left ventricular remodeling in patients with acute myocardial infarction.Results The triglyceride, LVEDV and LVESV in LVR group were significantly higher than those in non-LVR group, while LVEF and LVRI in LVR group were significantly lower than those in non-LVR group (P < 0.05). Compared with non-LVR group, the expression of lncRNA GAS5 in LVR group decreased significantly (P < 0.05). LncRNA GAS5 was negatively correlated with LVEDV and LVESV (r = -0.324 and -0.458, both P < 0.05), but positively correlated with LVEF and LVRI (r =0.376 and 0.395, both P < 0.05). LVEF [R = 3.152 (95% CI: 1.651, 6.016)], LVRI [R = 1.354 (95% CI: 1.137, 1.614)], and lncRNA GAS5 [R = 1.265 (95% CI: 1.346, 1.189)] were risk factors for left ventricular remodeling in patients with acute myocardial infarction. The optimal cutoff value of lncRNA GAS5 in diagnosis of left ventricular remodeling in patients with acute myocardial infarction was 0.812, in which area under ROC curve (AUC) was 0.827 (95% CI: 0.768, 0.891), with a sensitivity of 71.56% (95% CI: 0.603, 0.788) and a specificity of 82.66% (95% CI: 0.742, 0.923).Conclusions The decrease of serum lncRNA GAS5 level in patients with acute myocardial infarction is related to the occurrence of left ventricular remodeling, and has certain clinical value in the diagnosis of left ventricular remodeling.