Abstract: Objective To explore the relationship between the serum level of cysteine-rich angiogenic inducer 61 (CCN1) and the severity of chronic heart failure (CHF) in the elderly patients. Methods A total of 136 elderly patients with CHF were enrolled as case group and divided into Ⅱ, Ⅲ, Ⅳ subgroups according to the cardiac function class of New York Heart Association (NYHA). During the same period, 29 healthy elderly individuals were selected as control group. Serum levels of CCN1 and N-terminal pro-brain natriuretic peptide(NT-proBNP)of the two groups were detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was performed to evaluate the associations of CCN1 with NT-proBNP and left ventricular ejection fraction (LVEF). Multivariate logistic regression analysis was used to identify independent factors associated with NYHA grade Ⅲ-Ⅳ. The predictive value of serum CCN1 for NYHA grade Ⅲ-Ⅳ was evaluated by receiver operating characteristic (ROC) curve. Results Serum level of CCN1 was significantly increased in case group compared to control group(P<0.01), and was increased progressively with worsening CHF severity. Pearson analysis indicated that the level of serum CCN1 was positively correlated with NT-proBNP(r=0.662, P <0.001), whereas negatively correlated with LVEF(r=－0.493, P<0.001). Multivariate logistic regression analysis showed that CCN1 was independently associated with NYHA cardiac function class Ⅲ-Ⅳ after adjusting for other clinical variables (OR=1.124, 95%CI: 1.034－1.254, P=0.012). The ROC curve showed that serum CCN1 level had a good predictive value for NYHA grade Ⅲ-Ⅳ (AUC=0.959, 95%CI:0.917－0.984,P<0.001), with an ideal cutoff value of 2.826 pg/mL, sensitivity of 91.3%, specificity of 90.3% and Youden index of 0.816. Conclusions The serum level of CCN1 may act as a potential indicator to evaluate the severity of CHF in the elderly.

Key words: chronic heart failure, cysteine-rich angiogenic inducer 61, N-terminal pro-brain natriuretic peptide