Changes in levels of serum HMBG1 in chronic heart failure and its relationship with the condition and prognosis

ZHANG Dan; CHENG Wei; GAO Yanlin; RONG Li

doi:10.3969/j.issn.1002-266X.2025.01.002

Abstract：Objective To observe the changes of serum high-mobility group protein B1(HMGB1)levels in patients with chronic heart failure(CHF),and to explore the relationship between the levels and the severity and prognosis of pa-tients.Methods We selected 200 patients with CHF as the CHF group and 20 healthy subjects as the control group.Se-rum HMGB1 levels were detected by ELISA.According to the cardiac function grading method of New York Heart Associa-tion(NYHA),CHF patients were classified according to the severity of the disease.The patients were followed up for 24 months,and the occurrence of major adverse cardiovascular events(MACE)such as malignant arrhythmia,cardiogenic death,and all-cause death were recorded after discharge.Receiver operating characteristics(ROC)curve and the area un-der the curve were used to analyze the predictive value of serum HMGB1 for poor prognosis in CHF patients.Kaplan-Meier survival curve was used to analyze the difference in prognosis between patients with high and low serum HMGB1 expres-sion.Results The serum HMGB1 level in the CHF group was higher than that in the control group(P<0.05).Among 200 patients with CHF,41 cases were classified as grade Ⅱ,99 cases as grade Ⅲ,and 60 cases as grade Ⅳ.Serum N-terminal B-type natriuretic peptide precursor(NT-proBNP)and HMGB1 levels in CHF patients increased with the increase of NYHA cardiac function grading(all P<0.05).After 24 months of follow-up,65 of 200 CHF patients developed MACE and 135 did not develop MACE.The levels of serum NT-ProBNP and HMGB1 in CHF patients with MACE were higher than those in patients without MACE(both P<0.05).ROC curve analysis results showed that the AUC of serum HMGB1 and serum NT-ProBNP in predicting the occurrence of MACE in CHF patients was 0.752 and 0.772,respectively,and the AUC of serum HMGB1 combined with serum NT-probNP in predicting the occurrence of MACE in CHF patients was 0.863.Kaplan-Merier survival curve analysis showed that the incidences of poor prognosis in CHF patients with high and low serum HMGB1 levels were 67.50％and 35.50％,respectively,and the incidence of poor prognosis in patients with high HMGB1 level was higher than that in patients with low HMGB1 level(both P<0.05).Conclusion The serum HMGB1 level in CHF patients is elevated,which is related to the severity of the patients' disease,and the combined detec-tion of HMGB1 with serum NT-ProBNP can improve the accuracy of prognosis prediction.