Chronic Disease Control

The application value of serum osmolality, N-terminal pro-brain natriuretic peptide, and homocysteine in the early diagnosis of acute heart failure in patients with coronary heart disease and hypertension

  • Gangqiang XU ,
  • Zhaosuo HU ,
  • Long WANG ,
  • Runlin YUAN ,
  • Xin CAI ,
  • Zhengxu CHEN
Expand
  • 1.Department of Laboratory Medicine,Hefei Second People's Hospital (Anhui Medical University Affiliated Hefei Hospital),Hefei 230011,Anhui,Chin
    a2Department of Cardiovascular Medicine,Hefei Second People's Hospital (Anhui Medical University Affiliated Hefei Hospital),Hefei 230011,Anhui,China

Received date: 2025-12-02

  Revised date: 2025-12-31

  Accepted date: 2026-01-04

  Online published: 2026-03-26

Abstract

Objective To explore the application value of detecting serum osmotic pressure (SOSM) in combination with serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and homocysteine (Hcy) in patients with coronary heart disease and hypertension who suffer from acute heart failure. Methods A retrospective study was carried out on 130 patients with coronary heart disease and hypertension who visited the Second People's Hospital of Hefei from January 2023 to December 2024. Based on clinical diagnosis, they were divided into an acute heart failure (AHF) group consisting of 58 cases and a non-acute heart failure group with 72 cases. A control group of 64 patients with simple hypertension was selected during the same period. Serum NT-proBNP, Hcy, and LDL-C were measured in the three groups of patients. SOSM was calculated using serum sodium (Na), potassium (K), glucose (GLU), and urea (UREA) levels, and then a comparison was made to determine whether there were statistical differences in SOSM, NT-proBNP, LDL-C, and Hcy among the three groups. A binary logistic regression analysis was performed on the 130 observation subjects with coronary heart disease complicated by hypertension, and a good diagnostic indicator for acute heart failure in patients with coronary heart disease complicated by hypertension was obtained. The application value of Receiver Operating Characteristic (ROC) curve analysis of various indicator levels in acute heart failure in patients with coronary heart disease and hypertension was also explored. Results The differences in SOSM, Hcy, NT-proBNP, and LDL-C levels among the three groups were statistically significant (P < 0.05). The levels of NT-proBNP, SOSM, and Hcy in the AHF group were higher than those in the non-AHF group and the control group (P < 0.05). The ROC curves of the AHF group and the non-AHF group showed that the area under the ROC curve of the combined detection was 0.927, which was higher than that of each individual indicator. The sensitivity increased, and the specificity was high. Conclusion The combined detection of serum NT-proBNP, SOSM, and Hcy plays a crucial role in the early diagnosis and assessment of acute heart failure in patients with coronary heart disease and hypertension.

Cite this article

Gangqiang XU , Zhaosuo HU , Long WANG , Runlin YUAN , Xin CAI , Zhengxu CHEN . The application value of serum osmolality, N-terminal pro-brain natriuretic peptide, and homocysteine in the early diagnosis of acute heart failure in patients with coronary heart disease and hypertension[J]. The Journal of Practical Medicine, 2026 , 42(6) : 1018 -1023 . DOI: 10.3969/j.issn.1006-5725.2026.06.014

References

[1] CEASOVSCHIH A, BANJANIN N, BEDNAREK A, et al. Atherosclerotic features in patients with heart failure[J]. Arch Med Sci, 2025, 21(4): 1107-1129. doi:10.5114/aoms/208372 .
[2] BEECH D J. Are PIEZO1 channels a potential therapeutic target for heart failure? Getting to the heart of the matter[J]. Expert Opin Ther Targets, 2023, 27(6): 409-411. doi:10.1080/14728222.2023.2218999 .
[3] KHAN M S, SHAHID I, BENNIS A, et al. Global epidemiology of heart failure[J]. Nat Rev Cardiol, 2024, 21(10): 717-734. doi:10.1038/s41569-024-01046-6 .
[4] FATIMA A, HARIS MANSOOR M, MUNIR A, et al. Evaluation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a biomarker of cardiac dysfunction across heart failure phenotypes[J]. Cureus, 2025, 17(11): e96447. doi:10.7759/cureus.96447 .
[5] WANG T, LI R, GAO W, et al. Correlation of homocysteine with the risk of all-cause mortality in patients with coronary heart disease[J]. Front Cardiovasc Med, 2025, 12: 1624847. doi:10.3389/fcvm.2025.1624847 .
[6] BüYüKKARAG?Z B, BAKKALO?LU S A. Serum osmolality and hyperosmolar states[J]. Pediatr Nephrol, 2023, 38(4): 1013-1025. doi:10.1007/s00467-022-05668-1 .
[7] HU T, LI C, WANG T, et al. Serum osmolality was non-linearly associated with the risk of all-cause and cardiovascular mortality in patients with diabetes[J]. BMJ Open Diabetes Res Care, 2023, 11(6): e003826. doi:10.1136/bmjdrc-2023-003826 .
[8] 钱程昱, 王琳升, 熊兴江, 等. 血清低密度脂蛋白胆固醇、超敏C反应蛋白联合颈动脉超声参数诊断疑似冠心病患者的价值[J]. 实用医学杂志, 2025, 41(9): 1401-1406. doi:10.3969/j.issn.1006-5725.2025.09.019 .
[9] 中华医学会心血管病学分会介入心脏病学组, 中华医学会心血管病学分会动脉粥样硬化与冠心病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会, 等. 稳定性冠心病诊断与治疗指南[J]. 中华心血管病杂志, 2018, 46(9): 680-694. doi:10.3760/cma.j.issn.0253-3758.2018.09.004 .
[10] 中华医学会心血管病学分会, 中国医师协会心血管内科医师分会, 中国医师协会心力衰竭专业委员会, 等. 中国心力衰竭诊断和治疗指南2024[J]. 中华心血管病杂志, 2024, 52(3): 235-275. doi:10.3760/cma.j.cn112148-20231101-00405 .
[11] 中国高血压防治指南修订委员会, 高血压联盟(中国, 中国医疗保健国际交流促进会高血压病学分会, 等. 中国高血压防治指南(2024年修订版)[J]. 中华高血压杂志, 2024, 32(7): 603-700. doi:10.16439/j.issn.1673-7245.2024.07.002 .
[12] MUNK T, BECH C B, KLAUSEN T W, et al. Accuracy of the calculated serum osmolarity to screen for hyperosmolar dehydration in older hospitalised medical patients[J]. Clin Nutr ESPEN, 2021, 43: 415-419. doi:10.1016/j.clnesp.2021.03.014 .
[13] WANG X, ZHANG H, LU H, et al. Retinal microangiopathy as a marker of coronary atherosclerotic heart disease[J]. Int J Gen Med, 2025, 18: 4181-4193. doi:10.2147/IJGM.S532841 .
[14] MENSAH I K, ROEMMICH B, LAWLESS S, et al. Evaluation of three NT-proBNP assays for heart failure[J]. Clin Biochem, 2026, 141: 111062. doi:10.1016/j.clinbiochem.2025.111062 .
[15] LUNDGREN M, RIDEFELT P, SVENSSON M K, et al. NT-proBNP and its correlation to left ventricular ejection fraction and heart failure-The DEMONSTRATE database[J]. Ann Clin Biochem, 2025: 45632251403397. doi:10.1177/00045632251403397 .
[16] 程小兵, 罗娟娟, 陈燕, 等. 小而密低密度脂蛋白胆固醇及其与低密度脂蛋白胆固醇之比、同型半胱氨酸对颈动脉粥样硬化的影响[J]. 实用医学杂志, 2020, 36(19): 2684-2689. doi:10.3969/j.issn.1006-5725.2020.19.015 .
[17] PENG Y, OU B Q, LI H H, et al. Synergistic effect of atorvastatin and folic acid on cardiac function and ventricular remodeling in chronic heart failure patients with hyperhomocysteinemia[J]. Med Sci Monit, 2018, 24: 3744-3751. doi:10.12659/MSM. 906893 .
[18] HOOPER L, ABDELHAMID A, ALI A, et al. Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: Adding value to pathology laboratory reports[J]. BMJ Open, 2015, 5(10): e008846. doi:10.1136/bmjopen-2015-008846 .
[19] SIERVO M, BUNN D, PRADO C M, et al. Accuracy of prediction equations for serum osmolarity in frail older people with and without diabetes[J]. Am J Clin Nutr, 2014, 100(3): 867-876. doi:10.3945/ajcn.114.086769 .
[20] 中华医学会老年医学分会, 中国医师协会老年医学科医师分会. 中国老年人临床水化实践指南(2024版)[J]. 中华老年医学杂志, 2024, 43(8): 954-970. doi:10.3760/cma.j.issn.0254-9026.2024.08.002 .
[21] ZOU Q, LI J, LIN P, et al. Association between serum osmolality and 28-day all-cause mortality in patients with heart failure and reduced ejection fraction: A retrospective cohort study from the MIMIC-IV database[J]. Front Endocrinol, 2024, 15: 1397329. doi:10.3389/fendo.2024.1397329 .
[22] WANG S, ZHAO D, YANG T, et al. Association of serum osmolality with all-cause and cardiovascular mortality in US adults: A prospective cohort study[J]. Nutr Metab Cardiovasc Dis, 2023, 33(4): 844-852. doi:10.1016/j.numecd.2023.01.007 .
Outlines

/