Prognostic significance of brain-derived neurotrophic factor levels in patients with heart failure and reduced left ventricular ejection fraction

Objective: Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family. The aim of the present study was to investigate the relationship between BDNF levels and prognostic markers in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF), considering death or rehospitalization due to HF. Methods: Patients with severe left ventricular systolic dysfunction (LVEF <= 35%) and individuals with no history of cardiac disease (control group) were included in the study conducted between 2013 and 2017. Of the included patients, 52 were classified as mildly symptomatic [New York Heart Association (NYHA) I-II], and 108 were classified as severely symptomatic (NYHA III). The control group comprised 50 individuals. The primary endpoints of the study consisted of cardiovascular death during long-term follow-up and hospitalization for worsening of HF. Results: The mean age of the patient group was 67.60 +/- 11.45 years and 58% were male, whereas that of the control group was 66.28 +/- 11.30 years and 48% were male. The N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) serum levels in patients with HF were higher, whereas the BDNF values were lower than those in the control group (NT-pro-BNP: 5010 +/- 851 pg/mL vs. 33 +/- 11 pg/mL, p<0.001; BDNF: 8.64 +/- 1.12 ng/mL vs. 17.58 +/- 4.51 ng/mL, p<0.001). Multivariable analysis suggested that there was a significant association between BDNF levels and clinical status, generating the primary endpoints of death [BDNF levels: Odds ratio (OR)=0.17, 95% confidence interval (CI): 0.05-0.53, p=0.0021, and rehospitalization (BDNF levels: OR=0.702, 95% CI: 0.54-0.92, p=0.010). Conclusion: Decreased serum BDNF levels were associated with death and rehospitalization in patients with HF, suggesting that these levels can be useful prognostic biomarkers.