Abstract
OBJECTIVE: To evaluate the predictive value of soluble suppression of tumorigenesis-2 (sST2) for heart failure (HF) in children hospitalized with severe pneumonia. METHODS: A total of 109 children with severe pneumonia who were admitted to our hospital between January 2022 and December 2023 were selected. They were divided into HF and non-HF groups based on whether they developed HF. Clinical characteristics and clinical outcome data of the two groups were analyzed using relative factors analysis and logistic regression analysis. RESULTS: The HF and non-HF groups consisted of 35 and 74 patients, respectively. Significant differences were observed between the groups in terms of age [20.0 (11.0-38.0) vs. 60.0 (36.0-96.0) months, P < 0.001], body mass index (16.7 ± 2.0 vs. 18.3 ± 2.5 kg/m(2), P < 0.001), and body surface area (0.52 ± 0.13 vs. 0.75 ± 0.23 m(2), P < 0.001), with all values being lower in the HF group as compared to the non-HF group. Serum levels of sST2 (7.01 ± 2.31 vs. 4.38 ± 1.65 ng/mL, P < 0.001) and NT-proBNP [86.0 (78.5-108.5) vs. 65.0 (25.0-83.0) pg/mL, P < 0.001] were significantly higher in the HF group. The incidence of type I respiratory failure was also significantly higher in the HF group as compared to the non-HF group (45.7% vs. 25.7%, P = 0.005). Univariate logistic regression analysis revealed that age, body surface area, body mass index, type I respiratory failure, C-reactive protein level, NT-proBNP level, and sST2 level were significant risk factors for HF in children with severe pneumonia. Multivariate analysis identified sST2 levels > 5.84 ng/mL as an independent risk factor for HF [odds ratio (OR) = 3.974, 95% confidence interval (CI) 1.266-12.323, P = 0.003], with an area under the curve (AUC) of 0.828 (95% CI 0.718-0.927), sensitivity of 89.3%, and specificity of 78.8%. CONCLUSION: Elevated sST2 shows potential as an independent risk factor for HF in children with severe pneumonia, but further studies are needed before routine clinical adoption.