Objective To investigate the evaluation value of serum microRNA-19b-3p (miR-19b-3p) and microRNA-933 (miR-933) levels on cardiac function and prognosis in elderly patients with chronic heart failure.
Methods A total of 108 elderly patients with chronic heart failure were selected as study group. According to the New York Heart Society (NYHA) classification, 35 patients of the study group were classified into grade Ⅱ, 40 patients were classified into grade Ⅲ, and 33 patients were classified into grade Ⅳ. A total of 90 healthy people who underwent physical examination during the same period were selected as control group. Serum miR-19b-3p and miR-933 levels were detected after admission. Cardiac function parameters left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) were measured by echocardiography. The relationship between serum miR-19b-3p, miR-933 and cardiac function was analyzed by Pearson correlation method. Elderly patients with chronic heart failure were divided into occurrence group (n=34) and non-occurrence group (n=74) according to whether endpoint events occurred within one year of admission. The predictive value of serum miR-19b-3p and miR-933 in elderly patients with chronic heart failure was evaluated by receiver operating characteristic (ROC) curve. Multivariate Cox regression analysis was used to analyze the prognostic factors of elderly patients with chronic heart failure.
Results Serum levels of miR-19b-3p and miR-933 in the study group were significantly lower than those in the control group (P < 0.05). The levels of serum miR-19b-3p, miR-933 and LVEF in patients with cardiac function grade Ⅳ were significantly lower than those in patients with cardiac function grade Ⅲ, grade Ⅱ and healthy population, and LVEDD was larger than that in patients with cardiac function grade Ⅲ, patients with cardiac function grade Ⅱ and healthy population (P < 0.05). Serum miR-19b-3p level was positively correlated with LVEF and negatively correlated with LVEDD in elderly patients with chronic heart failure (r =0.554, -0.368, P < 0.001). Serum miR-933 level was positively correlated with LVEF and negatively correlated with LVEDD (r=0.505, -0.410, P < 0.001). The levels of serum miR-19b-3p and miR-933 in the occurrence group were significantly lower than those in the non-occurrence group (P < 0.05). The area under the curve (AUC) of serum miR-19b-3p and miR-933 to predict the prognosis of chronic heart failure in elderly patients were 0.835 (95%CI, 0.785 to 0.885) and 0.843 (95%CI, 0.790 to 0.890), and the AUC of the combined prediction was 0.901 (95%CI, 0.851 to 0.951). Serum miR-19b-3p (HR=3.762, 95%CI, 1.854 to 7.634), miR-933 (HR=3.480, 95%CI, 1.903 to 6.364) and National Institutes of Health Stroke Scale (NIHSS) score (HR=3.047, 95%CI, 1.837 to 5.051) were the prognostic factors of chronic heart failure in the elderly (P < 0.05).
Conclusion Serum miR-19b-3p and miR-933 levels are low in elderly patients with chronic heart failure. The changes of miR-19b-3p and miR-933 levels are closely related to cardiac function and prognosis, which can be used as effective indicators to predict poor prognosis in elderly patients with chronic heart failure.
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