Guoji laonian yixue zazhi (Jan 2024)
The Predictive Value of Reactive Oxygen Species Metabolic Derivative Before andAfter Exercise on the Prognosis of Elderly Patients with Heart Failure
Abstract
Objective To investigate the prognostic value of reactive oxygen species metabolic derivatives(D-ROM) in elderly patients with heart failure before and after cardiopulmonary exercise testing. Methods A prospective study was conducted on 300 elderly patients with acute heart failure admitted to Xinjiang Uygur Autonomous Region People's Hospital from July 2020 to September 2021.The patients were followed up for 1 year and divided into a poor prognosis group(45 cases) and a good prognosis group(255 cases) according to their prognosis.The clinical laboratory data of the patients were collected,and cardiopulmonary exercise tests were performed after the patients were stable to detect the serum D-ROM,superoxide dismutase(SOD),and malondialdehyde(MDA) levels before and after the test;left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left atrial diameter(LAD),inferior vena cava diameter(IVCD),and interventricular septum thickness(IVST) were measured by echocardiography.Multivariate logistic regression model was used to analyze the related factors affecting the prognosis of patients,and restricte. Results The poor prognosis group was older than the good prognosis group,the proportion of atrial fibrillation was higher than the good prognosis group,LVEDD,IVCD,IVST were longer than the good prognosis group,LVEF was lower than the good prognosis group,D-ROM and D-ROM after exercise were higher than the good prognosis group,the differences were statistically significant(P0.05).Multivariate logistic regression model analysis showed that LVEF,without atrial fibrillation were the independent protective factor for poor prognosis in elderly patients with heart failure(P<0.05),and age,D-ROM were independent risk factors for poor prognosis in elderly patients with heart failure(P<0.05).RCS curve analysis showed that there was a significant nonlinear relationship between D-ROM levels and the risk of adverse events within 1 year after discharge in patients with acute heart failure(P<0.001). Conclusion Changes in D-ROM before and after exercise are associated with a high degree of poor prognosis in elderly patients with heart failure.
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