Correlation of miR-21 and BNP with pregnancy-induced hypertension complicated with heart failure and the diagnostic value

Abstract

Correlation of miR-21 and B-type natriuretic peptide (BNP) with pregnancy-induced hypertension (PIH) complicated with heart failure and the diagnostic value was investigated. Sixty patients with PIH complicated with heart failure admitted to Affiliated Hospital of Chengde Medical University from July 2016 to July 2017 were enrolled as the experimental group, and 35 normal pregnant women as the control group. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) method was used to determine the expression level of plasma miR-21 expression level. An automatic biochemical analyzer was used to determine plasma BNP expression level. Spearmans correlation analysis was used for the correlation analysis of miR-21 and BNP. ROC curve was used for evaluating the diagnostic values of miR-21 and BNP for PIH complicated with heart failure. miR-21 and BNP expression levels were higher in patients with PIH complicated with heart failure than those in the normal individuals, and were increased in line with the heart failure grade (P<0.001). The plasma miR-21 expression was positively correlated with BNP in patients with PIH complicated with heart failure (r=0.685, P<0.001). Both miR-21 and BNP had higher diagnostic values for PIH complicated with heart failure, in the diagnosis, the best cut-off value [odds ratio (OR)] of miR-21 was 1.113, with an area under curve (AUC) of 0.889 and a 95% confidence interval (CI) of 82.05-95.76%; the OR of BNP was 123, with an AUC of 0.747 and a 95% CI of 64.95-84.38%. Blood pressure, six-minute walk test (6MWT), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were independent risk factors for the occurrence of PIH complicated with heart failure (P<0.05). In conclusion, miR-21 and BNP, highly expressed in patients with PIH complicated with heart failure, are expected to become important biomarkers for diagnosing PIH complicated with heart failure and judging the degree of heart failure in the patients, and worthy of clinical popularization and application.

Keywords: B-type natriuretic peptide; heart failure; miR-21; pregnancy-induced hypertension.

Figure 1.

Diagnostic value of miR-21 and BNP for PIH complicated with heart failure. The analysis of ROC curve showed that in the diagnosis of PIH complicated with heart failure, the OR of miR-21 was 1.113, the sensitivity was 88.53% and the specificity was 88.33%, with an AUC of 0.889 and a 95% CI of 82.05–95.76%; the OR of BNP cut-off value was 123, the sensitivity was 88.57% and the specificity was 63.33%, with an AUC of 0.747 and a 95% CI of 64.95–84.38%. BNP, B-type natriuretic peptide; PIH, pregnancy-induced hypertension; ROC, receiver operating characteristic; AUC, area under curve; CI, confidence interval; OR, odds ratio.

Figure 2.

Correlation analysis of miR-21 expression with BNP in PIH complicated with heart failure. The plasma miR-21 expression was positively correlated with BNP in patients with PIH complicated with heart failure (r=0.685, P<0.001). BNP, B-type natriuretic peptide; PIH, pregnancy-induced hypertension.