The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy.

BACKGROUND: Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). GDF-15 can predict the risk and the prognosis of cardiovascular disease, but its value is unclear in IIM. OBJECTIVE: To investigate the diagnostic value of GDF-15 for myocardial involvement in IIM. METHODS: A total of 77 IIM patients from May 2018 to August 2020 were included in this retrospective study. Of these, 43 patients underwent cardiac magnetic resonance (CMR) examination. There were 33 SLE patients and 16 healthy people were used as the control group. The concentration of GDF-15 of these groups was measured by ELISA. RESULTS: There were significant differences in GDF-15 levels in patients with IIM, SLE and healthy controls (H = 45.291, P<0.001). GDF-15 levels were statistically significant different between IIM patients with the myocardial injury [1484.88(809.07 2835.50) pg/ml] and without myocardial injury [593.26(418.61 784.59) pg/ml, P =0.001]. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased an average of 0.3% by per increased unit of GDF-15 (odds ratio=1.003, 95% CI: 1.000, 1.007). The level of GDF-15 was positively correlated with extra-cellular volume (ECV) (rs = 0.348, P =0.028). GDF-15 ≥ 929.505 pg/ml (area under the curve=0.856, 95% CI: 0.744, 0.968) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.90. CONCLUSION: GDF-15 could serve as a potential biomarker to predict myocardial injury in IIM patients.

Infinitely many weak solutions of the p-Laplacian equation with nonlinear boundary conditions.

We study the following p-Laplacian equation with nonlinear boundary conditions: -Δ(p)u + µ(x)|u|(p-2)u = f(x,u) + g(x,u),x ∈ Ω, | ∇u|(p-2)∂u/∂n = η|u|(p-2)u and x ∈ ∂Ω, where Ω is a bounded domain in ℝ(N) with smooth boundary ∂Ω. We prove that the equation has infinitely many weak solutions by using the variant fountain theorem due to Zou (2001) and f, g do not need to satisfy the (P.S) or (P.S*) condition.

Group-Based Trajectory Modeling of N-Terminal Pro-Brain Natriuretic Peptide Levels in Pulmonary Artery Hypertension Associated with Connective Tissue Disease.

Group-based trajectory modeling (GBTM) allows the trajectory analyses of repeated N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements during follow-up visits of pulmonary artery hypertension associated with connective tissue disease (CTD-PAH) patients. This study aimed to (1) identify trajectories of NT-proBNP changing over time, (2) explore the association between NT-proBNP trajectories and prognosis, and (3) explore the effects of baseline clinical characteristics on NT-proBNP trajectories. A retrospective, single-centred, observational study was performed on 52 CTD-PAH patients who had undergone at least three follow-up visits within 1 year from baseline. Four NT-proBNP trajectories were identified using GBTM: low stability (n = 15, 28.85%), early remission (remission within 3 months) (n = 20, 38.46%), delayed remission (remission after 6 or 9 months) (n = 11, 21.15%), and high stability (n = 6, 11.54%). The low-stability and early-remission trajectories were related to a similar positive prognosis, while the delayed-remission and high-stability trajectories were associated with a gradually worsening prognosis (p = 0.000). Intensive CTD immunotherapy (corticosteroids plus immunosuppressants) was the only factor that remained significant after least absolute shrinkage and selection operator regression and multivariate logistic regression, and was independently associated with a lower risk NT-proBNP trajectory (p = 0.048, odds ratio = 0.027, 95% confidence interval: 0.001-0.963), which preliminarily indicated a benefit of CTD-PAH patients undergoing intensive CTD immunotherapy.

The diagnostic value of serum YKL-40 for myocardial involvement in idiopathic inflammatory myopathy.

OBJECTIVE: To investigate the diagnostic value of serum chitinase-3-like-1 protein (YKL-40) levels for myocardial involvement in idiopathic inflammatory myopathies (IIM). METHODS: A total of 74 patients with definite IIM who visited Jiangsu Province People's Hospital between May 2018 and January 2022 were enrolled in this retrospective study. Baseline clinical evaluation, laboratory index, electrocardiogram (ECG), echocardiography (ECHO) and cardiac magnetic resonance (CMR) parameters were collected. Serum YKL-40 of all participants was determined by ELISA. Receiver-operating characteristic (ROC) curve was used to assess the diagnostic value of YKL-40 in assessing myocardial involvement in IIM patients. RESULTS: 1. YKL-40 concentration was significantly higher in IIM patients with myocardial injury than without myocardial injury.2. Multivariate logistic regression analysis demonstrated that serum YKL-40 was an independent risk factor for myocardial involvement in IIM.3. YKL-40 > 66.4 ng/ml (AUC = 0.85, 95 % CI 0.75-0.95) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.95. CONCLUSION: Serum YKL-40 could serve as a potential biomarker to predict myocardial injury in IIM patients.