Translational Medicine Centre, Jiangxi University of Chinese Medicine, Nanchang, 330004, China.
Department of Clinical Laboratory, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, 330006, China.
Sci Rep. 2024 May 17;14(1):11333. doi: 10.1038/s41598-024-61480-x.
The predictive power of B-type natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) is limited by its low specificity in patients with heart failure (HF). Discovery of more novel biomarkers for HF better diagnosis is necessary and urgent. ELABELA, an early endogenous ligand for the G protein-coupled receptor APJ (Apelin peptide jejunum, Apelin receptor), exhibits cardioprotective actions. However, the relationship between plasma ELABELA and cardiac function in HF patients is unclear. To evaluate plasma ELABELA level and its diagnostic value in HF patients, a total of 335 patients with or without HF were recruited for our monocentric observational study. Plasma ELABELA and Apelin levels were detected by immunoassay in all patients. Spearman correlation analysis was used to analyze the correlation between plasma ELABELA or Apelin levels and study variables. The receiver operating characteristic curves were used to access the predictive power of plasma ELABELA or Apelin levels. Plasma ELABELA levels were lower, while plasma Apelin levels were higher in HF patients than in non-HF patients. Plasma ELABELA levels were gradually decreased with increasing New York Heart Association grade or decreasing LVEF. Plasma ELABELA levels were negatively correlated with BNP, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular posterior wall thickness and positively correlated with LVEF in HF patients. In contrast, the correlation between plasma Apelin levels and these parameters is utterly opposite to ELABELA. The diagnostic value of ELABELA, Apelin, and LVEF for all HF patients was 0.835, 0.673, and 0.612; the sensitivity was 62.52, 66.20, and 32.97%; and the specificity was 95.92, 67.23, and 87.49%, respectively. All these parameters in HF patients with preserved ejection fraction were comparable to those in total HF patients. Overall, plasma ELABELA levels were significantly reduced and negatively correlated with cardiac function in HF patients. Decreased plasma ELABELA levels may function as a novel screening biomarker for HF. A combined assessment of BNP and ELABELA may be a good choice to increase the accuracy of the diagnosis of HF.
B 型利钠肽（BNP）和左心室射血分数（LVEF）的预测能力因其在心力衰竭（HF）患者中的低特异性而受到限制。因此，迫切需要发现更多用于 HF 更好诊断的新型生物标志物。ELABELA 是 G 蛋白偶联受体 APJ（Apelin 肽空肠，Apelin 受体）的早期内源性配体，具有心脏保护作用。然而，HF 患者血浆 ELABELA 与心功能之间的关系尚不清楚。为了评估 HF 患者血浆 ELABELA 水平及其诊断价值，共招募了 335 例 HF 或非 HF 患者进行单中心观察性研究。所有患者均采用免疫法检测血浆 ELABELA 和 Apelin 水平。采用 Spearman 相关分析分析血浆 ELABELA 或 Apelin 水平与研究变量之间的相关性。采用受试者工作特征曲线评估血浆 ELABELA 或 Apelin 水平的预测能力。HF 患者的血浆 ELABELA 水平较低，而 Apelin 水平较高。随着纽约心脏协会（NYHA）分级的增加或 LVEF 的降低，血浆 ELABELA 水平逐渐降低。HF 患者的血浆 ELABELA 水平与 BNP、左心房直径、左心室舒张末期直径、左心室收缩末期直径和左心室后壁厚度呈负相关，与 LVEF 呈正相关。相反，Apelin 水平与这些参数的相关性与 ELABELA 完全相反。ELABELA、Apelin 和 LVEF 对所有 HF 患者的诊断价值分别为 0.835、0.673 和 0.612；敏感性分别为 62.52%、66.20%和 32.97%；特异性分别为 95.92%、67.23%和 87.49%。HF 患者射血分数保留的这些参数与总 HF 患者相当。总体而言，HF 患者的血浆 ELABELA 水平显著降低，与心功能呈负相关。血浆 ELABELA 水平降低可能是 HF 的新型筛查生物标志物。联合评估 BNP 和 ELABELA 可能是提高 HF 诊断准确性的不错选择。
