Diagnostic Role of β2-Microglobulin in Children with Congestive Heart Failure due to Congenital Heart Disease

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Background: Heart failure (HF) is a frequent but challenging complication in children with congenital heart disease (CHD) due to vague symptoms. β2-microglobulin (β2-MG) shows promise as a cardiovascular biomarker, but its role in CHD-related pediatric HF is not well studied. This study aimed to determine the diagnostic value of serum β2-MG in children with HF due to CHD and explore its relationship with cardiac function Methods: This case-control study included 48 children: 24 with CHD and HF (case group) and 24 age- and gender-matched healthy controls. All participants underwent comprehensive clinical evaluation, laboratory assessments including serum β2-MG measurement by ELISA, and detailed echocardiographic examination. Results: Serum β2-MG levels were significantly higher in children with CHD and HF compared to controls (median 1.21 vs. 0.36 ng/ml, p<0.001), with levels progressively increasing with HF severity (mild: 0.733, moderate: 1.67, severe: 2.544 ng/ml). Significant negative correlations were observed between β2-MG and ejection fraction (r=-0.654, p<0.001), and medial E' velocity (r=-0.782, p<0.001). β2-MG had excellent diagnostic performance for heart failure at a cutoff of ≥0.6485 ng/ml, with 87.5% sensitivity, 91.7% specificity, 89.6% accuracy, and an AUC of 0.919. Conclusion: Serum β2-MG levels are significantly elevated in children with CHD and HF. It correlates with disease severity and cardiac dysfunction and demonstrates excellent diagnostic performance. These findings suggest that β2-MG may be a useful biomarker for early diagnosis and risk assessment. keywords: congenital heart disease; Heart failure; Biomarker; Echocardiography; Diagnostic value

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