Objective To investigate the correlation between serum nuclear factor E2-related factor 2 (Nrf2), silent regulatory protein 3 (SIRT3), perilipin 5 (PLIN5) and left ventricular remodeling (LVR) in patients with chronic heart failure (CHF), and its predictive value for prognosis.

Methods Two hundred patients with CHF were selected as the observation group, and another 100 healthy individuals undergoing physical examinations during the same period were selected as the control group. The levels of serum Nrf2, SIRT3, PLIN5 and LVR indicatorsleft ventricular end-diastolic posterior wall thickness (LVPWT), end-diastolic ventricular septal thickness (IVST), left ventricular mass index (LVMI) were compared between two groups. The Pearson method was used to analyze the correlation between serum Nrf2, SIRT3, PLIN5 and ventricular remodeling. The patients were followed up for 9 months, and divided into the good prognosis and poor prognosis patients according to the prognosis. The baseline data and levels of serum Nrf2, SIRT3 and PLIN5 of patients with different prognoses were compared. The logistic regression was used to analyze the relationship between serum Nrf2, SIRT3, PLIN5 and prognosis of CHF patients. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of serum Nrf2, SIRT3 and PLIN5 in predicting prognosis.

Results The levels of serum Nrf2, SIRT3 and PLIN5 in the observation group were lower than those in control group, while the values of LVPWT, IVST and LVMI were higher than those in control group (P ＜ 0.01). The results of Pearson analysis showed that the levels of serum Nrf2, SIRT3 and PLIN5 were negatively correlated with the values of LVR indicators LVPWT, IVST, and LVMI (P ＜ 0.05). There were statistically significant differences in the levels of troponin Ⅰ (cTnⅠ), brain natriuretic peptide (BNP), Nrf2, SIRT3 and PLIN5 among patients with different prognostic conditions (P ＜ 0.05). The results of logistic regression analysis showed that after adjusting for related confounding factors, the Nrf2, SIRT3 and PLIN5 were still the influencing factors for the prognosis of CHF patients (P ＜ 0.05). The ROC curve showed that the area under the curve (AUC) of Nrf2, SIRT3 and PLIN5 for predicting poor prognosis was 0.774, 0.796, and 0.757, respectively, and the AUC of the combined prediction was 0.933 (0.888−0.964). It was significantly higher than the single prediction efficacy of the three indicators (Z = 3.763, 3.022, 3.589, P = 0.000, 0.003, 0.000).

Conclusions The levels of serum Nrf2, SIRT3 and PLIN5 all have certain correlations with the LVR index of CHF patients. The combined detection has certain predictive value for poor prognosis, which can provide a reference for clinical assessment of LVR and prognosis prediction, and also guide clinical decision-making.