Expression and Clinical Significance of Serum sST2, BDNF, CTnI, and BUN/Cr in Patients With Heart Failure

Of the 26-million people suffering from heart failure worldwide, 80% require hospitalization for treatment every year. Biomarkers for clinical diagnosis and prognostic evaluation of heart failure may include: (1) growth-stimulating expression gene 2 protein (sST2), (2) blood urea nitrogen (BUN) and creatinine (Cr), (3) cardiac troponin I (CTnI), and (4) brain-derived neurotrophic factor (BDNP). At present, few studies have occurred on the expression of those biomarkers in patients with heart failure.

The study intended to investigate the expression and clinical significance of serum- soluble sST2, BDNF, CTnI, and BUN/Cr in patients with heart failure.

The research team designed a prospective controlled study.

The study took place at Renmin Hospital at the Hubei University of Medicine in Shiyan, Hubei, China.

Participants were 108 patients with heart failure who had been admitted to the hospital between March 2020 and March 2021 and 115 healthy individuals who received physical examinations during the same period.

The intervention group included the 108 participants with heart failure, and the control group included the healthy individuals. The research team further divided the intervention group into stage II, III, and IV groups, with 23, 65, and 20 patients, respectively.

The research team collected and compared the serum levels of sST2, BDNF, CTnI, BUN/Cr, and left ventricular ejection fraction (LVEF) between the groups. The team used the Pearson correlation analysis to analyze the correlation between each parameter and participants' cardiac function and multivariate logistic regression analysis to analyze the factors influencing heart failure.

No significant differences existed in age, gender, or disease course between the combined intervention groups and the control group at baseline (P > .05). The sST2, CTnI, and BUN/Cr levels of the combined intervention groups were significantly higher than those of the control group postintervention. In addition, the sST2, CTnI, and BUN/Cr levels significantly increased as the disease stage progressed (all P < .05). The levels of BDNF and LVEF in the combined intervention group were significantly lower than those in the control group postintervention, with the two parameters having significantly decreased in the intervention groups as the disease stage progressed (all P < .05). The Pearson correlation analysis found that the sST2, CTnI, and BUN/Cr were positively correlated with cardiac function, with r = 0.483, P = .017; r = .521, P = .011; r = 0.321, P = .021; r = 0.271, = .032; and r = 0.632, P = .007, respectively. The BDNF and LVEF were negatively correlated with cardiac function, with r = -0.43, P < .001 and r = -0.39, P < .001, respectively. With heart failure as the dependent variable, the logistic regression analysis showed that the sST2, CTnI, BUN, Cr, and BUN/Cr were the risk factors for heart failure, and the BDNF and LVEF were the protective factors against heart failure.

The serum sST2, CTnI, and BUN/Cr were highly expressed in patients with heart failure, while the expression of BDNF was low. Medical practitioners should pay attention to the risk factors sST2, CTnI, and BUN/Cr, and a higher BNDF indicates a better condition in patients with heart failure.