Objective: To investigate the change in the serum level of follistatin-like protein 1 (FSTL1) in children with chronic heart failure and its correlation with left ventricular remodeling.
Methods: A total of 45 children with chronic heart failure (CHF) between May 2014 and May 2015 were selected as the CHF group, among whom 21 had endocardial fibroelastosis (EFE) and 24 had dilated cardiomyopathy (DCM); another 30 healthy children were selected as the control group. Enzyme-linked immunosorbent assay was applied to measure the serum level of FSTL1. Radioimmunoassay was applied to measure N-terminal pro-brain natriuretic peptide, and echocardiography was applied to measure the indicators of left ventricular remodeling. The correlation between the serum level of FSTL1 and left ventricular remodeling was analyzed by Pearson correlation and Spearman′s rank correlation analysis.
Results: Before treatment, the CHF group had a significantly higher serum level of FSTL1 than the control group (P<0.05), which gradually increased with aggravation of CHF (P<0.05). The serum level of FSTL1 showed no significant difference between the EFE and DCM groups (P=0.176). Serum level of FSTL1 was positively correlated with left ventricular end-diastolic diameter (r=0.485, P=0.001), left ventricular mass (r=0.322, P=0.031), left ventricular mass index (r=0.353, P=0.017), and N-terminal pro-brain natriuretic peptide (r=0.562 P<0.001), and was negatively correlated with left ventricular ejection fraction (r=-0.436, P=0.003) and left ventricular minor axis decurtation rate (r=-0.436, P=0.003).
Conclusions: FSTL1 might take part in the left ventricular remodeling in children with CHF, and the serum level of FSTL1 can be used as an objective index for clinical diagnosis and severity assessment of CHF in children.
目的: 探讨卵泡抑素样蛋白1(FSTL1)在慢性心力衰竭(CHF)患儿血清中的变化及与左心室重构的相关性。
方法: 选取2014年5月至2015年5月CHF患儿45例为心衰组, 其中心内膜弹力纤维增生症21例, 扩张型心肌病24例; 另选取门诊健康儿童30例为健康对照组。采用酶联免疫吸附法测定血清FSTL1水平; 采用放射免疫分析法测定氨基末端脑利钠肽前体; 超声心动图测定左心室重构指标; Pearson相关或Spearman秩相关分析血清FSTL1与左心室重构指标的相关性。
结果: 心衰组治疗前血清FSTL1水平高于健康对照组(P < 0.05), 并随心衰程度加重而升高(P < 0.05)。心内膜弹力纤维增生症与扩张型心肌病患儿间血清FSTL1水平比较差异无统计学意义(P=0.176)。血清FSTL1与左心室舒张末径(r=0.485, P=0.001)、左心室质量(r=0.322, P=0.031)、左心室质量分数(r=0.353, P=0.017)、氨基末端脑利钠肽前体(r=0.562, P < 0.001)呈正相关, 与左室射血分数(r=-0.436, P=0.003)、左室短轴缩短率(r=-0.436, P=0.003)呈负相关。
结论: FSTL1可能参与CHF患儿左心室重构, 血清FSTL1可以作为儿童CHF临床诊断、病情评估的客观指标之一。