Predictive Value of Serum N-terminal Pro-B-type Natriuretic Peptide,Cardiac Troponin I and Uric Acid Levels for Ventricular Remodeling in Patients with Recalcitrant Heart Failure
HAN Caiping
HAN Xiao
LIU Dandan
WANG Haizhu
Abstract：Objective To observe the correlation between serum N-terminal pro-B-type natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),and uric acid(UA)levels and ventricular remodeling in patients with refractory heart failure,and to analyze the combined predictive value of these indicators.Methods A total of 100 patients with refractory heart failure admitted to Zhoukou Central Hospital from January 2021 to December 2022 were selected and divided into ventricular remodeling group and non-ventricular remodeling group based on the occurrence of ventricular remodeling 6 months after discharge.The general data,serum creatinine(Cr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),cystatin C(CysC),C-reactive protein(CRP),NT-proBNP,cTnI,and UA levels of the two groups were compared using x2 or t-tests.Binary logistic regression analysis was used to adjust and correct for confounding factors,and the independent predictive value of NT-proBNP,cTnI,and UA for ventricular remodeling was analyzed.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of the three indicators alone or in combination for ventricular remodeling.Results The age,serum Cr,BUN,NT-proBNP,cTnI,and UA levels in the ventricular remodeling group were higher than those in the non-ventricular remodeling group,and the eGFR level was lower than that in the non-ventricular remodeling group(P＜0.05).Age,Cr,BUN,and eGFR had collinearity problems.Binary logistic regression analysis adjusted and corrected for confounding factors such as age,Cr,BUN,and eGFR,and found that NT-proBNP,cTnI,and UA were all independent predictors of ventricular remodeling in patients with refractory heart failure(OR＞1,P＜0.05).The ROC curve showed that the area under the curve(AUC)values of serum NT-proBNP,cTnI,and UA alone for predicting ventricular remodeling in patients with refractory heart failure were 0.903,0.769,and 0.871,respectively,with cutoff values of 881.570 ng·L-1,0.360 μg·L-1,and 353.890 μmol·L-1,and sensitivities of 81.40％,70.48％,and 75.60％,and specificities of 82.90％,71.56％,and 76.32％,respectively.The AUC value of the combined prediction of the three indicators for ventricular remodeling in patients with refractory heart failure was 0.951,with a sensitivity of 93.33％and a specificity of 96.33％,both higher than the individual predictions(P＜0.001).Conclusion Serum NT-proBNP,cTnI,and UA are all predictive factors for ventricular remodeling in patients with refractory heart failure.NT-proBNP＞882 ng·L-1,cTnI＞0.36 μg·L-1,and UA＞354 μmol·L-1can be used for early screening of high-risk patients with ventricular remodeling,improving the predictive efficiency and providing a reference basis for early clinical intervention,thereby reducing the occurrence of ventricular remodeling and improving the prognosis of patients.
Keywords：recalcitrant heart failureventricular remodelingN-terminal pro-B-type natriuretic peptidecardiac troponin Iuric acid
Publication Date：2026-08-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 2762-2766 )