ABSTRACT
Objective:To investigate the expression and clinical significance of Apelin, Elabela(ELA), lipoprotein associated phospholipase A2 (LP-PLA2) in patients with hypertensive heart disease (HHD).Methods:One hundred and eight HHD patients treated in the Fuyang District Second People′s Hospital of Hangzhou City from June 2019 to June 2021 were collected as the observation group, and 108 essential hypertension (EH) patients without HHD during the same period were collected as the control group. The clinical indicators and the levels of Apelin, ELA and LP-PLA2 were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of Apelin, ELA and LP-PLA2 in predicting HHD. According to the median of Apelin, ELA and LP-PLA2, the patients were divided into high Apelin group and low Apelin group, high ELA group and low ELA group, high LP-PLA2 group and low LP-PLA2 group, with adverse cardiovascular events (MACE) as the end point. Kaplan-Meier method was used to plot the survival curve and Log-rank was used to test the difference between groups.Results:The course of EH in the observation group was longer than that in the control group: (8.74 ± 2.25) years vs. (4.72 ± 1.85) years; systolic pressure, diastolic pressure, N-terminal B-type natriuretic peptide (NT-proBNP), Apelin, ELA, LP-PLA2 were higher than those in the control group: (136.82 ± 11.47) mmHg (1 mmHg = 0.133 kPa) vs. (124.83 ± 12.72) mmHg, (82.52 ± 5.73)mmHg vs. (78.96 ± 5.95) mmHg, (3 624.35 ± 1 023.13) ng/L vs. (934.24 ± 352.53) ng/L, (5.16 ± 2.17) μg/L vs. (2.44 ± 1.97) μg/L, (182.72 ± 89.76) μg/L vs. (114.67 ± 46.22) μg/L; Apelin and left ventricular ejection fraction were lower than those in the control group: (28.75 ± 13.29) ng/L vs. (56.82 ± 19.84) ng/L, (52.16 ± 6.72)% vs. (58.63 ± 6.87)%, there were statistical differences ( P<0.05). Apelin was positively correlated with LVEF ( r = 0.530, P<0.05), while ELA and LP-PLA2 were negatively correlated with LVEF ( r = - 0.751, - 0.785, P<0.05). Apelin was negatively correlated with NT-proBNP ( r = - 0.358, P<0.05), ELA, LP-PLA2 were positively correlated with NT-proBNP ( r = 0.739 and 0.727, P<0.05). ROC curve analysis showed that the area under the curve values of Apelin, ELA and LP-PLA2 were 0.732, 0.761, 0.843. Logistic regression analysis showed that the course of EH ( OR = 1.325), Apelin ( OR = 0.563), ELA ( OR = 2.348) and LP-PLA2 ( OR = 2.573) were the risk factors of HHD ( P<0.05). Survival curve analysis showed that the incidence of MACE in the low Apelin group was higher than that in the high Apelin group, in the high ELA group was higher than that in the low ELA group, and in the high LP-PLA2 group was higher than that in the low LP-PLA2 group, there were statistical differences ( P<0.05). Conclusions:Apelin, ELA and LP-PLA2 can be used as reference indexes to predict EH complicated with HHD, and can help to judge the early prognosis of HHD patients.