CHI3L1 and heart failure: It has been shown that serum YKL-40 is closely associated with the early and late stages of the atherosclerotic process, and YKL-40 induces monocytes to mature into macrophages, which are then secreted by macrophages and activated macrophages at a later stage of differentiation (9).In addition, previous studies have shown that YKL-40 levels are higher in patients with myocardial infarction (10), stable coronary artery disease (11, 12), and heart failure (13).