AIM  To explore the application value of serum soluble angiotensin-converting enzyme 2 (sACE2), a disintegrin and metalloproteinase with thrombospondin-4 (Adamts4), and fatty acid-binding protein 4 (FABP4) in predicting the prognosis of chronic heart failure (CHF).

METHODS A total of 256 CHF patients admitted to our hospital from January 2021 to December 2022 were selected as the disease group. Based on their first-year follow-up outcomes after discharge, they were divided into a poor prognosis group (n=94) and a good prognosis group (n=162). Serum levels of sACE2, Adamts4, and FABP4 were tested by ELISA. Multivariate Logistic regression was used to identify the indicators influencing the prognosis of CHF. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of these indicators for the prognosis of CHF.

RESULTS Compared with the good prognosis group, the poor prognosis group showed significantly higher serum levels of Adamts4, sACE2, and FABP4, as well as reduced left ventricular ejection fraction (LVEF) (all P<0.01). Serum sACE2, Adamts4, FABP4, LVEF, and NT-proBNP were identified influencing indicators of the prognosis for CHF patients (P<0.05, P<0.01). The area under the curve (AUC) for the combined prediction of CHF prognosis using serum sACE2, Adamts4, and FABP4 was 0.894, which was better than individual predictions (Z_{combined - sACE2}=2.758, Z_{combined - Adamts4}=2.127, Z_{combined - FABP4}=4.060, P<0.01, p=0.033, P<0.01).

CONCLUSION Serum levels of sACE2, Adamts4, and FABP4 are significantly elevated in in CHF patients and are closely related to cardiac function grading. The combined detection of these three indicators can effectively predict the prognosis of CHF patients, demonstrating potential clinical application value.