AIM  To investigate the correlation between the changes of serum long non-coding RNA nuclear enriched abundant transcript 1 (lncRNA NEAT1) and Klotho levels and the severity of chronic heart failure (CHF) and ventricular remodeling.

  METHODS  A total of 112 patients with CHF admitted to the 95829 Military Hospital from March 2019 to March 2022 were selected as the CHF group. According to the criteria of the New York Heart Association (NYHA) cardiac function classification, they were divided into NYHA Class II group (n=38), NYHA Class III group (n=39), and NYHA Class IV group (n=35). During the same period, 108 healthy volunteers who underwent physical examination at the physical examination center of our hospital were selected as the control group, and ventricular remodeling indicators were measured by transthoracic echocardiography. Enzyme linked immunosorbent assay (ELISA) was used to detect laboratory indicators. The expression levels of lncRNA NEAT1 and Klotho in serum were detected by qRT-PCR. Pearson correlation was used to analyze the correlation between the expression levels of serum lncRNA NEAT1 and Klotho, as well as their correlation with ventricular remodeling indicators.

  RESULTS  Compared with the control group, ALT, TC, IL-6, TNF in the CHF group-α、 BNP and LDL-C levels were significantly increased (all P<0.01), while HDL-C levels were significantly decreased (P<0.05). Compared with the control group, the expression level of lncRNA NEAT1 in the serum of CHF group was significantly increased, while the expression level of Klotho was significantly decreased (all P<0.01). The expression level of serum lncRNA NEAT1 in patients with CHF in the NYHA class IV group was significantly higher than that in the NYHA class II group and the NYHA class III group, and the expression level in the NYHA class III group was significantly higher than that in the NYHA class II group; The expression level of serum Klotho in patients with CHF in the NYHA class IV group was significantly lower than that in the NYHA class II group and the NYHA class III group, while the expression level in the NYHA class III group was significantly lower than that in the NYHA class II group (all P<0.01). Correlation analysis showed that there was a negative correlation between the expression levels of lncRNA NEAT1 and Klotho in the serum of patients with CHF (r=−0.411, P<0.01). Compared with the control group, the values of IVST, LVEDd, and LVPWT in NYHA Class II, NYHA Class III, and NYHA Class IV groups increased significantly in turn, while the values of LVEF decreased significantly in turn (all P<0.01). The expression level of serum lncRNA NEAT1 was positively correlated with the values of IVST, LVEDd, and LVPWT, while negatively correlated with the values of LVEF; The expression level of Klotho in serum was positively correlated with the value of LVEF, and negatively correlated with the values of IVST, LVEDd, and LVPWT (all P<0.01).

  CONCLUSION  The expression level of serum lncRNA NEAT1 in CHF patients is obviously increased, while the expression level of Klotho is obviously decreased, which are related to the disease severity and ventricular remodeling in CHF patients.