Clinical Value of Serum sCD146 and MMP-9 in the Diagnosis of Secondary Heart Failure in Children with Congenital Heart Disease

ZHANG Chao; HAN Dong; FAN Dikun; GAO Jianchao; YANG Kan

doi:10.12102/j.issn.1672-1349.2025.23.019

Abstract：Objective: To explore the clinical value of serum soluble cluster of differentiation 146 (sCD146) and matrix metalloproteinase-9 (MMP-9) in diagnosing secondary heart failure in children with congenital heart disease. Methods: A total of 120 children with congenital heart disease admitted to Nanyang Central Hospital from June 2021 to May 2023 were selected. The children were divided into two groups based on whether they developed secondary heart failure: the secondary heart failure group (Group A, 65 cases) and the non-secondary heart failure group (Group B, 55 cases). Additionally, 30 healthy children who underwent physical examinations during the same period were selected as the control group (Group C). Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS) were measured using echocardiography. Serum levels of sCD146 and MMP-9 were determined using enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to evaluate the relationship between serum sCD146 and MMP-9 levels and LVEDV, LVESV, LVEF, and LVFS. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of serum sCD146 and MMP-9 levels for secondary heart failure in children with congenital heart disease. Results: LVESV in Group A was significantly higher than that in Group B, while LVEF and LVFS were significantly lower in Group A compared to Group B, with statistically significant differences (P < 0.05). Serum levels of sCD146 and MMP-9 in Groups A and B were higher than those in Group C, and Group A had higher levels of sCD146 and MMP-9 compared to Group B, with statistically significant differences (P < 0.05). Serum sCD146 and MMP-9 levels showed a negative correlation with LVEF and LVFS (P < 0.05), and a positive correlation with LVESV (P < 0.05). The area under the curve (AUC) for serum sCD146 and MMP-9 in diagnosing secondary heart failure in children with congenital heart disease were 0.828 and 0.883, respectively, with cut-off values of 175.60 ng/mL and 349.89 ng/L, sensitivity of 78.5% and 87.7%, and specificity of 74.5% and 80.0%, respectively. When combined, the AUC for serum sCD146 and MMP-9 in diagnosing secondary heart failure was 0.941, with higher sensitivity (89.2%) and specificity (85.5%) compared to individual diagnosis (Z for combined vs. sCD146 = 3.501, P = 0.001; Z for combined vs. MMP-9 = 2.712, P = 0.007). Conclusion: Serum sCD146 and MMP-9 levels are elevated in children with congenital heart disease who develop secondary heart failure, indicating their potential as diagnostic markers for heart failure.