Abstract
Background. Chronic heart failure (CHF) is an increasing public health issue, particularly among individuals over 30 years old. Modern diagnostic methods, including biomarkers, contribute to the early detection and monitoring of patients after myocardial infarction (MI). Key biomarkers include NT-proBNP, sST2, C-reactive protein (CRP), and cardiomyocyte microRNAs.
Aim. To assess the diagnostic significance of biomarkers of endothelial dysfunction and myocardial fibrosis in patients with varying severity of CHF after MI.
Methods. Patients were divided into three groups based on left ventricular ejection fraction (LVEF). Inclusion criteria: consent to participate, CHF diagnosis, and MI diagnosis upon hospitalization. Exclusion criteria: oncology, blood disorders, heart defects, and history of coronary artery bypass grafting. The diagnostic process included medical history collection, echocardiography, coronary angiography, and biochemical analysis. On the first day, coronary angiography was performed to assess coronary artery stenosis (≥70% considered significant, ≥50% for LCA and RCA). Within 48 hours, systolic and diastolic left ventricular function was assessed. On the third day, venous blood was collected to analyze CRP, NT-proBNP, sST2, and VEGF levels. Data analysis was performed using R statistical software, including methods for evaluating differences, relationships between variables, and logistic regression (p<0.05).
Results. Patients with reduced LVEF had significantly elevated NT-proBNP and sST2 levels (p<0.05). VEGF levels showed no significant differences among the groups. The analysis demonstrated that increased NT-proBNP and sST2 levels correlate with CHF severity. The development of adverse cardiovascular events within a year was associated with renal dysfunction and elevated CRP, NT-proBNP, and sST2 levels.
Conclusions. A significant correlation was found between NT-proBNP and sST2 levels and LVEF in CHF patients after MI. High levels of these biomarkers are characteristic of HFrEF, confirming their association with worsening cardiac function. VEGF levels did not show significant variation depending on CHF severity.
Keywords: chronic heart failure, laboratory diagnostics, biomarkers of myocardial damage, inflammatory processes.
For citation: Trusov Yu.А., Bogdanov K.M., Sustretov A.S., Shchukin Yu.V. Diagnostic significance of biomarkers of endothelial dysfunction and myocardial fibrosis in patients with different severity of chronic heart failure after myocardial infarction. Clinical review for general practice. 2025; 6 (8): 69–77 (In Russ.). DOI: 10.47407/kr2025.6.08.00p4534
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