USE OF ST2 BIOMARKER IN DIAGNOSTICS OF CHRONIC HEART FAILURE ON THE BACKGROUND OF ESSENTIAL HYPERTENSION
DOI:
https://doi.org/10.11603/mcch.2410-681X.2023.i1.13744Keywords:
sST2, marker, essential hypertension, chronic heart failureAbstract
Introduction. Timely diagnosis of heart dysfunction with the development of chronic heart failure (CHF) against the background of essential hypertension (EН) is an urgent problem of modern cardiology. Soluble ST2 (sST2), involved in cardioprotection, may be a promising biomarker.
The aim of the study – to improve the diagnosis of heart dysfunction in the case of CHF in patients with EН by determining the plasma concentration of sST2.
Research Methods. 150 men with confirmed EН, aged from 40 to 60 years, were examined: 100 people with EН without signs of CHF, 50 patients with EН and CHF (CH II A stage, II–III functional class). In all patients, the plasma concentration of sST2 was determined by the ELISA method, and an echocardiographic study was performed according to a standard protocol.
Results and Discussion. It was found that the level of sST2 in the blood plasma of patients with EН and CHF is significantly higher than in men with EН without CHF (28.20±1.59) ng/ml vs. (24.10±1.12) ng/ml, p≤0.01). It was determined that in patients with EН, the level of the marker is significantly higher in the presence of left ventricular hypertrophy (LVH) (p≤0.01), diastolic dysfunction (DD) (p≤0.01), and in the group of EG and CHF – with ejection fraction (ЕF) LV is less than 40 % (р≤0.05). The obtained results made it possible to propose threshold levels of sST2: an indicator above 25.00 ng/ml as a marker of LVH in men with EН (AUC=0.70, 95 % CI=0.62-0.78, p=0.042, sensitivity 64.8 %, specificity 82.5 %); the indicator above 26.32 ng/ml as a marker of LVEF is less than 40 % in patients with EН and CHF (AUC=0.64, 95 % CI=0.50-0.80, p=0.045, sensitivity 61.5 %, specificity 66.4 %).
Conclusions. A high plasma level of sST2 in men with EН and CHF is associated with the presence of LVEF, DD and a significant decrease in LVEF less than 40 %. Cutoff levels of sST2 can be used as markers of LVH and significant reduction in LVEF in patients with EН and CHF with sufficient sensitivity and specificity.
References
Kwok, C.S., Zieroth, S., Van Spall, H.G.C., Helliwell, T., Clarson, L., Mohamed, M., Mallen, C., Duckett, S., & Mamas, M.A. (2020). The Hospital Frailty Risk Score and its association with in-hospital mortality, cost, length of stay and discharge location in patients with heart failure short running title: Frailty and outcomes in heart failure. International Journal of Cardiology, 300, 184-190. DOI: 10.1016/j.ijcard.2019.09.064 DOI: https://doi.org/10.1016/j.ijcard.2019.09.064
Lund, L. H., Savarese, G., Venkateshvaran, A., Benson, L., Lundberg, A., Donal, E., … & Hage, C. (2022). Eligibility of patients with heart failure with preserved ejection fraction for sacubitril/valsartan according to the PARAGON-HF trial. ESC Heart Failure, 9 (1), 164-177. DOI: 10.1002/ehf2.13705 DOI: https://doi.org/10.1002/ehf2.13705
Núñez, J., de la Espriella, R., Rossignol, P., Voors, A.A., Mullens, W., Metra, M., … & Bayes-Genis A. (2022). Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology. European Journal of Heart Failure, 24 (10), 1751-1766.DOI: 10.1002/ejhf.2664 DOI: https://doi.org/10.1002/ejhf.2664
Hongisto, M., Lassus, J., Tarvasmäki, T., Sionis, A., Sans-Rosello, J., Tolppanen, H., … & CardShock Study Investigators and the GREAT Network (2021). Mortality risk prediction in elderly patients with cardiogenic shock: results from the CardShock study. ESC Heart Failure, 8 (2), 1398-1407. DOI: 10.1002/ehf2.13224 DOI: https://doi.org/10.1002/ehf2.13224
Tygla, O.S. (2019) Prognostic significance of biomarker ST2 in patients with hypertension on the background of COPD. Ukrainian Journal of Medicine, Biology and Sport, 4 (20), 146-151. DOI: 10.26693/jmbs04.04.146 [in Ukrainian]. DOI: https://doi.org/10.26693/jmbs04.04.146
Borovac, J.A., Glavas, D., Susilovic Grabovac, Z., Supe Domic, D., Stanisic, L., D'Amario, D., ... & Bozic, J. (2020). Circulating sST2 and catestatin levels in patients with acute worsening of heart failure: a report from the CATSTAT-HF study. ESC Heart Failure, 7 (5), 2818-2828. DOI: https://doi.org/10.1002/ehf2.12882
Feng, Z., Akinrimisi, O.P., Gornbein, J.A., Truong, Q.A., Das, S., Singh, J.P. & Ajijola O. (2021) Combination biomarkers for risk stratification in patients with chronic heart failure biomarkers prognostication in HF. J. Card Fail., 18, 1071-9164(21)00241-4. DOI: 10.1016/j.cardfail.2021.05.028. DOI: https://doi.org/10.1016/j.cardfail.2021.05.028
Yamamoto, M., Seo, Y., Ishizua, T., Nakagawa, D., Sato, K., Machino-Ohtsuka, T., … & Ieda, M. (2021). Comparison of soluble ST2, pentraxin-3, galectin-3, and high-sensitivity Troponin T of cardiovascular outcomes in patients with acute decompensated heart failure. Journal of Cardiac Failure, 27 (11), 1240-1250. DOI: 10.1016/j.cardfail.2021.05.025 DOI: https://doi.org/10.1016/j.cardfail.2021.05.025
Coglianese, E.E., Larson, M.G., Vasan, R.S., Ho, J.E., Ghorbani, A., McCabe, E.L., … & Januzzi, J.L. (2012). Distribution and clinical correlates of the interleukin receptor family member soluble ST2 in the Framingham Heart Study. Clinical Chemistry, 58 (12), 1673-1681. DOI: https://doi.org/10.1373/clinchem.2012.192153
Coronado, M.J., Bruno, K.A., Blauwet, L.A., Tschöpe, C., Cunningham, M.W., Pankuweit, S., … & Fairweather, D. (2019). Elevated sera sST2 is associated with heart failure in men ≤50 years old with myocarditis. Journal of the American Heart Association, 8 (2), e008968. DOI: 10.1161/JAHA.118.008968 DOI: https://doi.org/10.1161/JAHA.118.008968
Najjar, E., Faxén, U.L., Hage, C., Donal, E., Daubert, J. C., Linde, C., & Lund, L.H. (2019). ST2 in heart failure with preserved and reduced ejection fraction. Scandinavian Cardiovascular Journal: SCJ, 53 (1), 21-27. DOI: 10.1080/14017431.2019.1583363 DOI: https://doi.org/10.1080/14017431.2019.1583363
Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.E., Jr, Colvin, M.M., … & Westlake, C. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation, 136 (6), e137-e161. DOI: 10.1161/CIR.0000000000000509 DOI: https://doi.org/10.1161/CIR.0000000000000509
Kolesnyk, M., Sokolova, M.V., Nikityuk, O.V., Horlova, I.V. (2021) Dynamics of left ventricle myocardial deformation, soluble ST2 and cardiotrophin-1 in hypertensive women on combined valsartan / hydrochlorothiazide therapy. European Heart Journal – Cardiovascular Imaging, 22, Jeaa356.113. DOI: 10.1093/ehjci/jeaa356.113 DOI: https://doi.org/10.1093/ehjci/jeaa356.113
Farcaş, A.D., Anton, F.P., Goidescu, C.M., Gavrilă, I.L., Vida-Simiti, L.A., & Stoia, M.A. (2017). Serum soluble ST2 and diastolic dysfunction in hypertensive patients. Disease markers, 2017, 2714095. DOI: 10.1155/2017/2714095 DOI: https://doi.org/10.1155/2017/2714095
Pascual-Figal, D.A., Lax, A., Perez-Martinez, M.T., del Carmen Asensio-Lopez, M., Sanchez-Mas, J. (2015) Clinical relevance of sST2 in cardiac diseases. Clinical Chemistry and Laboratory Medicine (CCLM), 54 (1). DOI: 10.1515/cclm-2015-0074. DOI: https://doi.org/10.1515/cclm-2015-0074
Wong, C.W., Tafuro, J., Azam, Z., Satchithananda, D., Duckett, S., Barker, D., ... & Kwok, C.S. (2021). Misdiagnosis of heart failure: A systematic review of the literature. Journal of Cardiac Failure, 27 (9), 925-933. DOI: https://doi.org/10.1016/j.cardfail.2021.05.014
Voronkov, L.G., Amosova, K.M., Dziak, G.V., Zharinov, O.Y., Kovalenko, V.M., Korkushko, O.V. ... & Sychev O.S. Recommendations of the Association of Cardiologists of Ukraine on diagnosis and treatment of chronic heart failure. (2017) Heart failure and comorbid conditions. Special issue. Supplement No. 1 to the journal “Heart failure and comorbid conditions”, 1, 64 [in Ukrainian]
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., … & ESC Scientific Document Group (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 39 (33), 3021-3104. DOI: 10.1093/eurheartj/ehy339 DOI: https://doi.org/10.1093/eurheartj/ehy439
Nagueh, S.F., Smiseth, O.A., Appleton, C.P., Byrd, B.F., 3rd, Dokainish, H., Edvardsen, T., … & Waggoner, A.D. (2016). Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 29 (4), 277-314. DOI: 10.1016/j.echo.2016.01.011 DOI: https://doi.org/10.1016/j.echo.2016.01.011
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Medical and Clinical Chemistry
This work is licensed under a Creative Commons Attribution 4.0 International License.