Abstract
Objective:To investigate the pathogenic characteristics of pulmonary infection in hospitalized patients with chronic heart failure as well as the diagnostic value of soluble myeloid cell expression triggering receptor-1 (sTREM-1), soluble CD163 (sCD163) and soluble tumor necrosis factor-like weak inducing factor (sTWEAK).Methods:A total of 72 patients with pulmonary infection who were hospitalized with chronic heart failure from December 2017 to December 2019 in the Department of Cardiology of Hebei Baoding Huaying Hospital of Traditional Chinese Medicine, China, were selected as the infection group, seventy-two patients without pulmonary infection who were hospitalized with chronic heart failure were selected as the non-infection group, and 50 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group. The distribution characteristics of pathogens in the infection group were statistically analyzed. The levels of sTREM-1, S CD163 and STweak in serum of patients with different infection severity and different cardiac function grades were compared among the three groups. Receiver operating characteristic curve (ROC) was utilized to evaluate the predictive value of the three indicators for the adverse prognosis of patients in hospital.Results:A total of 76 strains of pathogens were cultured from two hospitalized patients with pulmonary infection of chronic heart failure, among which 43 strains (56.58%) were gram-negative bacteria, 29 strains (38.15%) were gram-positive bacteria, and four strains (5.26%) were fungi. The levels of sTREM-1 and sCD163 in the control group, non-infection group and infection group were gradually increased (p<0.05), while there was no difference in sTWEAK between the infection group and the non-infection group (p>0.05). In the infection group, the expression levels of sTREM-1 and sCD163 increased with the severity of infection, with statistically significant differences (p<0.05), while there was no statistically significant difference in the expression level of sTWEAK among different infection severity (p>0.05). The higher the cardiac function grade of patients in the infection group, the higher the levels of sTREM-1 and sCD163, and the lower the level of sTWEAK, with a statistical significance (p<0.05). ROC analysis results showed that the serum sTREM-1, sCD163, and sTWEAK levels for the poor prognosis of patients with CHF combined with lung infection had areas under the curve of 0.864, 0.870, and 0.822, respectively, and the 95% CI values were 0.787-0.941, 0.795-0.945 and 0.733-0.910, respectively, all p<0.001.Conclusions:Pulmonary infection in hospitalized patients with chronic heart failure is mainly caused by gram-negative bacteria. Detection of sTREM-1, sCD163, and sTWEAK levels is of certain value in judging the condition and prognosis, which is worthy of clinical promotion.
Highlights
According to the survey of “Report on Cardiovascular Diseases in China (2017)”, the prevalence of cardiovascular diseases inPak J Med Sci March - April 2022 Vol 38 No 3 www.pjms.org.pk 536China continues to rise, and deaths caused by cardiovascular diseases rank as the primary cause of death among urban and rural residents in China.[1]
No statistically significant difference was observed in the soluble tumor necrosis factor-like weak inducing factor (sTWEAK) level between the infection group and the non-infection groups (p>0.05), while the sTWEAK level between the infection and the non-infection group was lower than that of the control group (p
Receiver operating characteristic curve (ROC) analysis results showed that the serum soluble myeloid cell expression triggering receptor-1 (sTREM-1), soluble CD163 (sCD163), and sTWEAK levels for the poor prognosis of patients with chronic heart failure (CHF) combined with lung infection had areas under the curve of 0.864, 0.870, and 0.822, respectively, and the 95% CI values were 0.787-0.941, 0.795-0.945 and 0.733-0.910, respectively, with statistical significance (p
Summary
According to the survey of “Report on Cardiovascular Diseases in China (2017)”, the prevalence of cardiovascular diseases inPak J Med Sci March - April 2022 Vol 38 No 3 www.pjms.org.pk 536China continues to rise, and deaths caused by cardiovascular diseases rank as the primary cause of death among urban and rural residents in China.[1]. Investigating the characteristics of its pathogens is helpful for physicians to accurately select antimicrobial agents, improve the therapeutic effect and reduce the burden on patients.[2,3] It has been reported in previous studies that some commonly used laboratory indicators, such as C-reactive protein (CRP) and procalcitonin (PCT), have been used in the clinical diagnosis and prognosis of pulmonary infection in patients with CHF. The clinical diagnosis and prognosis of pulmonary infection are not ideal owing to the problem of reasonable sensitivity but insufficient specificity of these indicators. It is, a trend of future research to combine multiple biomarkers for the diagnosis and prognosis of diseases.[4,5]
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