Abstract:

Objective To discuss the differences in serum proline dehydrogenase （ProDH） levels among chronic heart failure （CHF） patients with different ejection fraction types， and to clarify the effect of ProDH levels on cardiac function. Methods A retrospective analysis of clinical data of 118 CHF patients was conducted. These patients were divided into heart failure with reduced ejection fraction （HFrEF） group （n=39）， heart failure with mid-range ejection fraction group （HFmrEF） （n=42）， and heart failure with preserved ejection fraction （HFpEF） group （n=37）. A total of 45 non-CHF patients hospitalized during the same period were collected as control group. The general data of all the subjects in various groups were collected， and the levels of biochemical indicators and cardiac structure indicators in serum of all the subjects were detected. Spearman correlation analysis and point-biserial correlation analysis were used to analyze the correlation between serum ProDH levels and various biochemical indicators； multivariate Logistic regression analysis was used to analyze the factors influencing HFrEF and HFmrEF. Results Compared with control group， the usage rate of beta-blockers of the patients in HFpEF group was significantly increased （P<0.05）； in HFmrEF group， the percentage of male patients， the usage rate of statins， and the usage rate of beta-blockers were all significantly increased （P<0.05）； in HFrEF group， the age and systolic blood pressure （SBP） of the patients were significantly decreased （P<0.05）， while the usage rates of statins and beta-blockers of the patients were significantly increased （P<0.05）. Compared with HFpEF group， the age of the patients in HFmrEF group was significantly decreased （P<0.05）， and the percentage of male patients and the usage rate of statins were significantly increased （P<0.05）； the age of the patients in the HFrEF group was significantly decreased （P<0.05）， and the usage rate of statins was significantly increased （P<0.05）. Compared with HFmrEF group， the SBP of the patients in HFrEF group was significantly decreased （P<0.05）.Compared with control group， the serum levels of low-density lipoprotein cholesterol （LDL-c） of the patients in HFpEF and HFmrEF groups were significantly decreased （P<0.05）， while the levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） were significantly increased （P<0.05）； the serum levels of glomerular filtration rate （GFR） and ProDH of the patients in HFrEF group were significantly decreased （P<0.05）， and the levels of fasting blood glucose （FBG） and NT-proBNP were significantly increased （P<0.05）. Compared with HFpEF group， the serum hemoglobin （Hb） level of the patients in HFmrEF group was significantly increased （P<0.05）； the serum NT-proBNP level of the patients in HFrEF group was significantly increased （P<0.05）， while the ProDH level was significantly decreased （P<0.05）. Compared with HFmrEF group， the serum NT-proBNP level of the patients in HFrEF group was significantly increased （P<0.05）.Compared with control group， the left atrial diameter （LAD） and the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity （E/Em） of the patients in HFpEF， HFmrEF， and HFrEF groups were significantly increased （P<0.05）； the left ventricular end-diastolic diameter （LVEDD） of the patients in HFmrEF and HFrEF groups were significantly increased （P<0.05）， and the left ventricular ejection fraction （LVEF） were significantly decreased （P<0.05）. Compared with HFpEF group， the LVEDD of the patients in HFmrEF and HFrEF groups were significantly increased （P<0.05）， and the LVEF were significantly decreased （P<0.05）； the LAD of the patients In HFrEF group was significantly increased （P<0.05）. Compared with HFmrEF group， the E/Em ratio of the patients in HFrEF group was significantly increased （P<0.05）， and the LVEF was significantly decreased（P<0.05）. The serum ProDH levels of the patients were negatively correlated with LVEDD （r=-0.210， P=0.007） and positively correlated with LVEF （r=0.220， P=0.005）. Male and elevated FBG levels were the risk factors for cardiac function， while the increasing serum GFR and ProDH levels were the protective factors for cardiac function. Conclusion There are differences in ProDH levels among the CHF patients with different ejection fraction types. The patients with poorer cardiac function have lower serum ProDH levels， and higher ProDH levels may be beneficial for improving the left ventricular systolic function in the CHF patients.KEDWORDS Proline dehydrogenase； Chronic heart failure； Heart failure with reduced ejection fraction； Heart failure with mid-range ejection fraction； Heart failure with preserved ejection fraction