Role of Specific Neuro-hormonal and Inflammatory Laboratory Markers as Indicators of Severity in Ischemic Heart Failure

Background Ischemic cardiomyopathy (ICM), is the leading global cause of heart failure. Neurohormonal activation and inflammatory pathways are key contributors to disease progression. This study was conducted to evaluate the relationship between baseline levels of specific neurohormonal and inflammatory biomarkers and the clinical severity of ischemic heart failure. Methods: A cross-sectional observational study was conducted at Kobri Al-Kobba Specialized Cardiology Hospital and El-Maadi Military Medical Complex, Cairo, Egypt, between December 2023 and September 2024. A total of 140 ischemic heart failure patients were included. All participants underwent detailed history taking, echocardiography, 24-hour Holter monitoring, and laboratory measurement of neurohormonal norepinephrine, plasma renin activity, aldosterone, endothelin-1 and inflammatory TLC, NLR, CRP markers. The main outcome was the association of these biomarkers with disease severity indices, including (EF), (PASP), (TAPSE), (LVEDD) and NYHA class. Results: The mean age was 63.7 ± 13.4 years, with 55% males. Significant negative correlations were found between norepinephrine, aldosterone, endothelin-1, TLC, NLR, and CRP with ejection fraction (EF) and tricuspid annular plane systolic excursion (TAPSE) (p2 seconds, NYHA class, atrial fibrillation incidence, pulmonary artery systolic pressure (PASP), and left ventricular end-diastolic diameter (LVEDD) (p<0.05 for all). Plasma renin activity showed no significant correlation with any severity parameter. Conclusion: Neurohormonal and inflammatory biomarkers show significant associations with the severity of ischemic heart failure and may serve as useful adjuncts for clinical risk stratification.