# Plasma HMGB1 as a Potential Biomarker Reflecting the Clinical Outcome in Chronic Heart Failure Patients

## TL;DR

This study shows that high levels of HMGB1 in the blood may indicate worse outcomes for patients with chronic heart failure.

## Contribution

The study identifies plasma HMGB1 as a potential biomarker for disease severity and prognosis in chronic heart failure.

## Key findings

- Elevated HMGB1 levels correlate with worse clinical indicators like pulmonary artery pressure and NYHA class.
- Higher HMGB1 levels are strongly associated with shorter overall survival in CHF patients.
- HMGB1 effectively distinguishes between different stages of heart failure and nutritional status.

## Abstract

Background: Chronic heart failure (CHF) is a progressive cardiovascular disease that predominantly affects elderly individuals and significantly impairs quality of life. High mobility group box 1 (HMGB1) has been proposed as a key mediator in the myocardial release of proinflammatory cytokines and the progression of CHF. The primary aim of this retrospective study was to evaluate the clinical significance of plasma HMGB1 levels in patients with CHF. The secondary objective was to determine the prognostic and predictive value of plasma HMGB1. Methods: Prior to the commencement of the study, blood samples were collected from 145 patients diagnosed with CHF. Plasma HMGB1 concentrations were measured at a single baseline time point using the enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed to assess correlations between HMGB1 levels and cardiac, laboratory, and nutritional parameters. Results: Elevated HMGB1 levels were significantly associated with worse clinical status, including increased pulmonary artery systolic pressure (PASP, p = 0.011), enlarged right ventricular outflow tract (RVOT, p = 0.006), advanced New York Heart Association (NYHA) functional class III or IV (p < 0.001), and the presence of dyspnea at rest (p < 0.001). HMGB1 levels effectively distinguished between NYHA classes I–III and IV (AUC = 0.780), as well as between cachectic and non-cachectic individuals (AUC = 0.840). Importantly, higher plasma HMGB1 concentrations were significantly associated with shorter overall survival (OS) in CHF patients (HR = 2.03; p < 0.001). Conclusions: Plasma HMGB1 levels may suggest that they reflect both cardiac and nutritional status in patients with CHF and could serve as a valuable biomarker for disease severity and prognosis. Notably, elevated HMGB1 is strongly associated with reduced overall survival, supporting its potential use in risk stratification and clinical management of CHF.