BNP-guided therapy optimizes the timing of discharge and the medium term risk stratification in patients admitted for congestive heart failure

Household Fluorescent Lateral Flow Strip Platform for Sensitive and Quantitative Prognosis of Heart Failure Using Dual-Color Upconversion Nanoparticles

Heart failure (HF) is the end-stage of cardiovascular diseases, which is associated with a high mortality rate and high readmission rate. Household early diagnosis and real-time prognosis of HF at bedside are of significant importance. Here, we developed a highly sensitive and quantitative household prognosis platform (termed as UC-LFS platform), integrating a smartphone-based reader with multiplexed upconversion fluorescent lateral flow strip (LFS). Dual-color core-shell upconversion nanoparticles (UCNPs) were synthesized as probes for simultaneously quantifying two target antigens associated with HF, i.e., brain natriuretic peptide (BNP) and suppression of tumorigenicity 2 (ST2). With the fluorescent LFS, we achieved the specific detection of BNP and ST2 antigens in spiked samples with detection limits of 5 pg/mL and 1 ng/mL, respectively, both of which are of one order lower than their clinical cutoff. Subsequently, a smartphone-based portable reader and an analysis app were developed, which could rapidly quantify the result and share prognosis results with doctors. To confirm the usage of UC-LFS platform for clinical samples, we detected 38 clinical serum samples using the platform and successfully detected the minimal concentration of 29.92 ng/mL for ST2 and 17.46 pg/mL for BNP in these clinical samples. Comparing the detection results from FDA approved clinical methods, we obtained a good linear correlation, indicating the practical reliability and stability of our developed UC-LFS platform. Therefore, the developed UC-LFS platform is demonstrated to be highly sensitive and specific for sample-to-answer prognosis of HF, which holds great potential for risk assessment and health monitoring of post-treatment patients at home.