AIM To investigate the assessment of baseline human epididymal protein 4 (HE4) levels and drug responsiveness in patients with dilated cardiomyopathy (DCM).
METHODS 106 patients with DCM who were admitted to the Cardiovascular Department of the Hospital from January 2018 to December 2021 were selected as the study subjects. They were treated with standardized drugs in accordance with the Chinese Guidelines for the Diagnosis and Treatment of Dilated Cardiomyopathy. All general information was recorded, and baseline serum HE4 levels were detected by chemiluminescence method. Three months later, 2 patients lost their visits due to relocation. 104 patients were followed up, and 64 patients were classified into the response group, The other 40 cases were classified as non response group. Multivariate Logistic was used to screen the influencing factors of drug therapy responsiveness, and ROC curve was drawn to evaluate the efficacy of related factors in predicting drug therapy responsiveness. Restrictive cubic spline was used to fit the baseline serum HE4 level and drug therapy responsiveness.
RESULTS Compared with the non reaction group, cTnI, NT-proBNP, HE4 and LVEDD in the reaction group decreased; Multivariate logistic regression analysis showed that baseline serum NT-proBNP (OR=1.002, 95% CI:1.001～1.003, P<0.01), HE4 (OR=1.049, 95% CI:1.001～1.100, P<0.05), LVEDD (OR=1.265, 95% CI:1.080～1.481, P<0.05), cTnI (OR=1.752, 95% CI:1.019～3.012, P<0.01) were risk factors for drug unresponsiveness in DCM patients. ROC curve showed that the AUC of HE4 predicting the drug response of DCM patients was 0.672 (95% CI:0.512～0.707), the specificity was 53.13%, and the sensitivity was 75.00%; NT-proBNP predicted AUC of 0.802 (95% CI:0.756～0.908), specificity of 81.25%, and sensitivity of 70.00%; CTnI predicted AUC of 0.613 (95% CI:0.506～0.720), specificity of 79.69%, sensitivity of 40.00%; LVEDD predicted AUC of 0.715 (95% CI:0.610～0.820), specificity of 78.10%, and sensitivity of 62.50%; There was no statistically significant difference between the above indicators. The restricted cubic spline showed that there was a nonlinear dose response relationship between the baseline serum HE4 level and the treatment responsiveness of DCM patients (P<0.05).
CONCLUSION Serum HE4 levels, NT-proBNP, cTnI and LVEDD are associated with drug treatment responsiveness in DCM patients and continuous changes in serum HE4 levels show a dose-response relationship with treatment responsiveness in DCM patients.
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