The reported 1-year mortality following hospitalization for acutely decompensated HF is estimated at nearly 30% and the approach to evaluation and management of the HF patient is complex. Accordingly, with increasingly diverse medical and nonmedical strategies to treat patients with HF, it is important for physicians to accurately assess the risk of patients in order to tailor their therapies. Determination of circulating biomarkers has been suggested as a meaningful approach to reflect biological process and predict the outcomes in HF. In this regard, over recent years, the natriuretic peptides have been well recognized as important risk predictors in HF. However natriuretic peptides alone are insufficient to explain the complexity of pathophysiologic pathways in HF. Therefore, other biomarkers might be useful to improve risk stratification and prognostication for patients with HF. ST2 is a member of the interleukin -1 receptor family with transmembrane and soluble forms. Clinically, many studies have shown that elevated concentrations of sST2 are associated with adverse events in patients with acute myocardial infarction, HF and dyspnea. Additionally, the ability of sST2 to prognostic was recently found to be superior to another novel biomarker, galectin-3, in patients with chronic HF. Despite these encouraging results, no data exist regarding the prognostic value of sST2 measurement in patients with HF from Asia, a distinctly different ethnic group, with diverse medical issues compared to Western Torin 1 populations. Therefore, the purpose of this study was to investigate the clinical characteristics of sST2 and evaluate the prognostic values in a large cohort of Chinese hospitalized patients with HF. In this cohort of 1528 hospitalized patients with HF, we present the first large scale analysis of sST2 measurement in Asia. These results are especially meaningful because more than half of the study participants were from diffuse geographic regions across China. In contrast to United States registries of hospitalized patients with ADHF, patients in our study were much younger, were mostly male, and had relatively low systolic blood pressure. So the results of our study will be important to better understand the characteristics of sST2 on hospitalized patients with HF in China. Therefore, our study was designed to prove and extend the association between sST2 and adverse events. The process of HF is considered to be accompanied with inflammation. ST2, a member of IL-1 receptor family, had been found to possess immunomodulatory functions, particularly regarding CD4+ T-helper 2 lymphocytes. Beyond this, however, sST2 plays a role in the development of cardiac fibrosis and hypertrophy by modulating IL-32/ST2 signaling system. In response to mechanical stimulation, the transcript for both sST2 and ST2L are up-regulated, and sST2 can act as a decoy receptor for IL-33 competitively inhibiting the cardioprotective function of ST2L. In this context, sST2 appears to be associated with the process of HF progression; thus, sST2 has been found to predict cardiac risk quite potently. With the local availability of a recently developed highly sensitive sST2 assay came the opportunity to specifically examine the role of this biomarker in Asian populations. We found some notable characteristics of sST2 in our study participants. When categorized by ischemic etiology, sST2 concentrations were higher in patients with non-ischemic HF etiology than patients with ischemic HF etiology, but this may have been due to the fact that the proportion of patients with NYHA functional class IV was higher in non-ischemic groups.