Evaluation of ST2 as an early marker of heart failure with a preserved left ventricular ejection fraction in patients with persistent atrial fibrillation
https://doi.org/10.15829/1560-4071-2020-1-3705
Abstract
Aim. To assess the diagnostic value of soluble ST2 (sST2) for early detection of heart failure with a preserved ejection fraction (HFpEF) in patients with persistent atrial fibrillation (AF).
Material and methods. A total of 165 patients hospitalized with AF paroxysm were examined. The inclusion criteria were the persistent AF and LVEF >50% according to echocardiography. A cohort of 60 patients with persistent AF and preserved LVEF was formed. Patients were divided into 2 equal groups of 30 people depending on the HF presence, assessed on the basis of LV diastolic dysfunction with or without left atrial enlargement >34 ml/m2 or left ventricular mass index >110 g/m2 in men and 95 g/m2 in women, as well as an increase in the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) >125 pg/ml. LVEF was calculated using the Simpson method; assessment of LV diastolic function was carried out with determination of transmitral flow velocity characteristics and visualization of mitral annulus motion. The NT-proBNP concentration was determined in blood serum using the Biomedica Group reagent (Austria), sST2 — using Presage ST2 (Critical Diagnostics, USA) by enzyme-linked immunosorbent assay on an Immulite 1000 analyzer (DPC, USA).
Results. In patients with HFpEF and persistent AF, the correlation analysis showed a direct strong relationship between NT-proBNP and sST2 (r=0,726; p<0,05). To assess sST2 as a diagnostic criterion for HF, ROC curve was constructed. It was shown that with sST2 ≥16 ng/ml (AUC=0,89), the sensitivity of the method was 80%, the specificity — 83%.
Conclusion. In patients with a persistent AF, serum sST2 concentration ≥16 ng/ml can be used as an alternative to the NT-proBNP criterion for early diagnosis of HFpEF.
About the Authors
E. A. Polyanskaya
E. A. Wagner Perm State Medical University
Russian Federation
Perm
Russian Federation
Perm
N. A. Koziolova
E. A. Wagner Perm State Medical University
Russian Federation
Perm
Russian Federation
Perm
S. V. Mironova
E. A. Wagner Perm State Medical University
Perm
Perm
References
1. Список литературы:
2. Cornelis J, Myers J, Heidbuchel H et al. Exercise Training in Heart Failure Patients With Persistent Atrial Fibrillation: a Practical Approach. Cardiac Failure Review. 2018;4(2):107–11. doi: https://doi.org/10.15420/cfr.2018.19.2.
3. Villacorta H, Maisel A. Soluble ST2 Testing: A Promising Biomarker in the Management of Heart Failure. Arq Bras Cardiol. 2016; 106(2): 145–152. doi:10.5935/abc.20150151.
4. Januzzi JL, Pascual-Figal D, Daniels LB. ST2 testing for chronic heart failure therapy monitoring: the International ST2 Consensus Panel. Am J Cardiol. 2015;115(7 Suppl):70B-5B. doi: 10.1016/j.amjcard.2015.01.044.
5. Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263-71. doi: 10.1016/j.jacc.2013.02.092.
6. Aimo A, Januzzi JL Jr, Bayes-Genis A et al. Clinical and Prognostic Significance of sST2 in Heart Failure: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;74(17):2193-203. doi: 10.1016/j.jacc.2019.08.1039.
7. AbouEzzeddine OF, McKie PM, Dunlay SM et al. Suppression of Tumorigenicity 2 in Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc. 2017;6(2):e004382. doi:10.1161/JAHA.116.004382.
8. Najjar E, Faxén UL, Hage C et al. ST2 in heart failure with preserved and reduced ejection fraction. Scand Cardiovasc J. 2019; 53(1):21-7. doi: 10.1080/14017431.2019.1583363.
9. Farcaş AD, Anton FP, Goidescu CM et al. Serum Soluble ST2 and Diastolic Dysfunction in Hypertensive Patients. Dis Markers. 2017;2017:2714095. doi:10.1155/2017/2714095.
10. Bayes-Genis A, Januzzi JL, Gaggin HK, et al. ST2 pathogenetic profile in ambulatory heart failure patients. J Card Fail. 2015;21(4):355-61. doi: 10.1016/j.cardfail.2014.10.014.
11. Dattagupta A, Immaneni S. ST2: Current status. Indian Heart J. 2018;70 Suppl 1(Suppl 1):S96–S101. doi:10.1016/j.ihj.2018.03.001.
12. Ramadan AM, Daguindau E, Rech JC, et al. From proteomics to discovery of first-in-class ST2 inhibitors active in vivo. JCI Insight. 2018;3(14):e99208. doi:10.1172/jci.insight.99208.
13. Felker GM, Fiuzat M, Thompson V et al. Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes. Circ Heart Fail. 2013; 6(6):1172-9. doi: 10.1161/CIRCHEARTFAILURE.113.000207.
14. Lancellotti P, Dulgheru R, Magne J et al. Elevated Plasma Soluble ST2 Is Associated with Heart Failure Symptoms and Outcome in Aortic Stenosis. PLoS One. 2015;10(9):e0138940. doi:10.1371/journal.pone.0138940.
15. Wang YC, Yu CC, Chiu FC et al. Soluble ST2 as a biomarker for detecting stable heart failure with a normal ejection fraction in hypertensive patients. Card Fail. 2013; 19(3):163-8. doi: 10.1016/j.cardfail.2013.01.010.
16. Chen C, Qu X, Gao Z et al. Soluble ST2 in Patients with Nonvalvular Atrial Fibrillation and Prediction of Heart Failure. Int Heart J. 2018;59(1):58-63. doi: 10.1536/ihj.16-52.
Review
For citations:
Polyanskaya E.A., Koziolova N.A., Mironova S.V. Evaluation of ST2 as an early marker of heart failure with a preserved left ventricular ejection fraction in patients with persistent atrial fibrillation. Russian Journal of Cardiology. 2020;25(1):3705. (In Russ.) https://doi.org/10.15829/1560-4071-2020-1-3705
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