Serum Brain-Derived Neurotrophic Factor Level at Discharge Predicts the Prognosis in Patients with Heart Failure

Background: Skeletal muscle has recently been identified as an organ that produces and releases cytokines, named “myokines”. Brain derived neurotropic factor (BDNF), a neurotrophic factor family, is one of myokines and plays a key role in regulating survival, growth and maintenance of neurons. We investigated whether serum BDNF level at discharge could predict the prognosis in patients with heart failure (HF). Methods: We prospectively enrolled 94 patients who were hospitalized for worsening HF and had cardiac rehabilitation. Functional status was evaluated by using cardiopulmonary exercise test (CPX) to measure peak oxygen uptake (PeakVO₂) at discharge. We measured serum BDNF level before CPX. Results: Although correlation was not observed between BDNF and PeakVO₂ (r = 0.167), slight correlation was observed between BDNF and VE vs VCO₂ slope (r = −0.220). Receiver operating characteristic (ROC) curve was used to detect the optimal cut-off point of BDVF (19.22 ng/ml) to estimate event free rate. Kaplan-Meier analysis demonstrated that cardiac death or rehospitalization due to worsening HF was significantly higher in the low BDNF group (P = .02). Multivariate analysis adjusted for Age, peakVO₂ and VE vs VCO₂ slope found BDNF as an independent factor of adverse events (hazard ratio 0.94, 95% confidence interval 0.90–0.99, P < .01). Conclusions: Serum BDNF level at discharge may be a useful biomarker for the prognosis in patients with HF.