Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Wang, Zefeng; Cheng, Liao‐Ping; Zhang, Junmeng; Liang, Zhuo; Dong, Ruijuan; Hang, Fei; Wang, Xinlu; Wang, Ziyu; Wu, Yongquan; Du, Jie

doi:10.12659/msm.926221

Cited by 13 publications

(17 citation statements)

References 25 publications

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“…Moreover, Walek et al reported that sST2 was a predictor of successful electrical cardioversion and long-term maintenance of sinus rhythm (SR) in persistent AF patients (18). Wang et al reported that sST2 levels were higher in paroxysmal AF patients with left atrial low-voltage zone (LVZ) > 20% compared with those with a smaller LVZ, and elevated sST2 levels served as a novel predictor of paroxysmal AF recurrence rate in patients who had undergone ablation (19). Persistent AF patients normally have a more severe fibrotic atrium than paroxysmal AF patients (20), which promote us to investigate the diagnostic value of sST2 in the setting of persistent AF.…”

Section: Introductionmentioning

confidence: 99%

Circulating Soluble Suppression of Tumorigenicity 2 Predicts Recurrence After Radiofrequency Ablation of Persistent Atrial Fibrillation

Tan

Liu

et al. 2021

Front. Cardiovasc. Med.

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Objective: A more extensively fibrotic left atrium contributes to atrial fibrillation (AF) occurrence, persistence, and recurrence. The soluble suppression of tumorigenicity 2 (sST2) has emerged as a ventricular fibrotic biomarker for patients with heart failure. The present study is to investigate associations between circulating sST2 and risk of recurrence after ablation in AF patients.Methods: We measured the baseline plasma level of sST2 from patients with persistent AF (n = 117) and paroxysmal AF (n = 93) patients. Patients were followed up for 15 months after ablation. The relationship between circulating sST2 and recurrence was assessed by multivariable Cox regression. The cutoff value of sST2 was determined by receiver operating characteristic curve. The relationship between baseline sST2 level and left atrial volume index (LAVI) was assessed by multivariate linear regression analysis. Serial sST2 measurements were also conducted after 24 h, 6 months, and 15 months of ablation. ST2 localization was examined in left atrial appendages of persistent AF patients by immunohistochemistry and Western blot.Results: Baseline sST2 positively associated with LAVI in the persistent AF group, and elevated sST2 (≥39.25 ng/ml) independently increased the risk of recurrence after ablation (area under the curve = 0.748), with hazard ratio of 1.038 (95% confidence interval 1.017–1.060, P < 0.001) when adjusted for co-variables. In contrast, elevated sST2 cannot predict recurrence in paroxysmal AF.Conclusions: In persistent AF patients, increased sST2 serves as a marker of recurrence after radiofrequency ablation. Patients with sST2 ≥ 39.25 ng/ml are more likely to develop recurrence within a year.

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Section: Introductionmentioning

confidence: 99%

Circulating Soluble Suppression of Tumorigenicity 2 Predicts Recurrence After Radiofrequency Ablation of Persistent Atrial Fibrillation

Tan

Liu

et al. 2021

Front. Cardiovasc. Med.

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“…Okar and colleagues reported that soluble ST2, as measured prior to an ablation procedure, is an independent parameter for predicting AF recurrence [ 11 ]. Other studies have suggested that sST2 was associated with LA volume enlargement, the LA low-voltage zone, and LV myocardium abnormalities in patients with paroxysmal AF [ 12 , 13 ]. Similar to the above findings, our results indicate that the median sST2 concentration of the pAF group was 12.76 ± 4.73 ng/ml, higher than that of the SR group.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Biomarkers in Paroxysmal Atrial Fibrillation: A Single Center Cross‐Sectional Study

Sun

Wang

et al. 2022

Contrast Media & Molecular Imaging

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The clinical risk profile of paroxysmal atrial fibrillation (pAF) patients is inconclusive. We aimed to identify clinical and laboratory biomarkers in patients with pAF and the differences in biomarkers among genders. A cross-sectional study was conducted with a total of 181 participants in a single center in Beijing Anzhen Hospital. The participants were grouped according to the presence of pAF and sex differences, and clinical and laboratory results were collected and compared. The 181 participants had a mean age of 52.9 ± 15.1 years (pAF group, 60.4 ± 9.9 years, SR group, 48.3 ± 15.9 years, P < 0.05). Patients with pAF had significantly higher rates of age, left atrial (LA) diameter, haemoglobin (Hb) levels, tissue inhibitor of metalloproteinase-1 (TIMP-1), soluble tumour suppressor-2 (sST2), B-type natriuretic peptide (BNP) and indirect bilirubin (Ibil), mean haemoglobin concentration (MCHC), and hypertension (HTN) and smoking (P < 0.05). Multivariable logistic regression analysis revealed that age (OR = 1.075, 95% CI: 1.035–1.118, P < 0.0001), smoking (OR = 4.538, 95% CI: 1.559–13.205, P = 0.006), and MCHC (OR = 1.062, 95% CI: 1.019–1.106, P = 0.004) were independent predictive factors for pAF. Multivariable logistic regression analysis found that age (OR = 1.107, 95% CI: 1.016–1.206, P = 0.02) and Ibil level (OR = 2.303, 95% CI: 1.158–4.582, P = 0.017) were independent predictive factors of the occurrence of pAF in females; BNP (OR = 1.015, 95% CI: 1.002–1.029, P = 0.029) was an independent predictive variable of pAF in males. Age, smoking, and MCHC were independent predictive factors of pAF. BNP was an independent predictive biomarker of pAF in males, while in females, age and Ibil were independent predictive factors.

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“…Serum soluble ST2 (sST2) is a family member of the interleukin-1 receptors. It can be found on cardiac myocytes and fibroblasts [29,30]. In experimental models, the interaction between interleukin 33 (IL-33) and ST2 seems to be protective, reducing fibrosis, hypertrophy, and apoptosis.…”

Section: Sst2mentioning

confidence: 99%

“…Elevated sST2 levels in acute heart failure patients predict both rehospitalization and mortality. Research shows that sST2 is probably an objective biomarker that can predict AF patients' risk of an emergency admission or heart failure (HF), and elevated sST2 concentration may be involved in the progression of AF [30,32].…”

Section: Sst2mentioning

confidence: 99%

Cardiac fibrosis and atrial fibrillation

Mickiewicz

Lisowska

Knapp

2022

Postępy Higieny I Medycyny Doświadczalnej

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Cardiac fibrosis is characterized by the imbalance of production and degradation of the extracellular matrix. The result of this process is an accumulation of scar tissue, which is associated with many pathological processes such as excessive mechanical stress on the heart, inflammation, ischemia, oxidative stress, or excessive neurohormonal activation. Fibrotic response results in damaged heart architecture and dysfunction of the heart. Cardiac fibrosis leads to increased stiffness of the left ventricle and arteries, promotes disorders of contraction and relaxation of the heart, disrupts electrophysiology of heart cells, and induces arrhythmias. Atrial fibrillation is one of the most common arrhythmias. It is associated with a deterioration in the quality of life and more frequent use of medical assistance. It is also an instantaneous risk factor for many diseases, including stroke. The underlying cause of this arrhythmia is electrical and structural remodeling induced by cardiac fibrosis. Therefore, much attention is paid to the search for biochemical markers that would allow non-invasive determination of the degree of this fibrosis. The promising markers include galectin-3, human epididymis protein 4 (HE4), serum soluble ST2, and adipose triglyceride lipase (ATGL). Studies have shown that plasma concentrations of these substances reflect the degree of myocardial fibrosis and are indirectly associated with AF. There are high hopes for the use of these markers in patients undergoing arrhythmia ablation. More research is needed to confirm that these markers can be used to estimate the chance of maintaining sinus rhythm in patients after ablation.

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Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Cited by 13 publications

References 25 publications

Circulating Soluble Suppression of Tumorigenicity 2 Predicts Recurrence After Radiofrequency Ablation of Persistent Atrial Fibrillation

Circulating Soluble Suppression of Tumorigenicity 2 Predicts Recurrence After Radiofrequency Ablation of Persistent Atrial Fibrillation

Clinical and Laboratory Biomarkers in Paroxysmal Atrial Fibrillation: A Single Center Cross‐Sectional Study

Cardiac fibrosis and atrial fibrillation

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