AIM To study and analyze the expression levels of serum DExD/H-Box helicase 58 (DDX58) and miR-224-3p in patients with ischemic heart failure and their relationship with heart function and ventricular remodeling.

METHODS A total of 270 patients with ischemic heart failure admitted to our hospital from July 2021 to July 2024 were included for this study. According to the New York Heart Association (NYHA) cardiac function classification, the patients were grouped into grade II (85 cases), grade III (106 cases), and grade IV (79 cases) as well as the mild group (grade II, n=85) and the severe group (grade III+IV, n=185), and another 270 healthy volunteers who underwent regular physical examinations served as the control group. ELISA and qRT-PCR methods were applied to detect the expression levels of DDX58 and miR-224-3p in the serum of the patients and general clinical data of the patients were collected and analyzed. Spearman Pearson method was applied to analyze the correlation between DDX58, miR-224-3p, heart function grading and ventricular remodeling indicators, including left ventricular end systolic diameter (LVEDD), left ventricular end diastolic diameter (LVESD), left ventricular anterior posterior diameter (LAD) and left ventricular ejection fraction (LVEF), and multivariate logistic regression was applied to analyze the influencing factors of the occurrence and the severity of the condition.

RESULTS Compared with the control group, the DDX58 level was significantly increased and the miR-224-3p level was significantly decreased in patients with ischemic heart failure in the diseased group (both P<0.05); DDX58 is a risk factor for ischemic heart failure, while miR-224-3p is a protective factor for ischemic heart failure (both P<0.01); Compared with patients with grade II, patients with grade III and IV had significantly increased levels of DDX58 and significantly decreased levels of miR-224-3p (both P<0.05); Compared with mild patients, severe patients showed no significant differences in age, gender, smoking, alcohol consumption, blood glucose, urea nitrogen, TG, AST, ALT, body mass index (BMI), etc., but had a higher proportion of hypertension, decreased LVEF, increased LVEDD, increased LVESD, increased LAD, increased BNP, and increased Scr (all P<0.05). DDX58 is positively correlated with cardiac function grading, LVEDD, LVESD, LAD, BNP, and negatively correlated with LVEF (all P<0.05); MiR-224-3p was negatively correlated with cardiac function grading, LVEDD, LVESD, LAD, and BNP, and positively correlated with LVEF (all P<0.05); And LVEF and serum miR-224-3p levels are protective factors for the severity of the patient's condition, while hypertension, BNP, LVEDD, LVESD, LAD, and serum DDX58 levels are risk factors affecting the severity of the patient's condition (P<0.05, P<0.01).

CONCLUSION In patients with ischemic heart failure, the expression level of DDX58 is greatly increased, while the expression level of miR-224-3p is greatly reduced, which is correlated with the heart function and ventricular remodeling.