ST2 in patients with severe aortic stenosis and heart failure

Cai, Andrew; Miyazawa, Alejandra Andrea; Sunderland, Nicholas; Piper, Susan; Gibbs, Thomas; Wang, Duolao; Redding, Sadie; Amin-Youseff, George; Wendler, Olaf; Byrne, Jonathan; MacCarthy, Philip; Shah, Ajay M.; McDonagh, Theresa A.; Dworakowski, Rafał

doi:10.5603/cj.a2019.0052

Cited by 13 publications

(10 citation statements)

References 15 publications

(18 reference statements)

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“…Fabiani et al [126] found that sST2 ≥ 284 ng/mL had the best accuracy for predicting altered global longitudinal strain in patients with severe AS. However, sST2 levels before TAVR were not significantly different between HF patients and AS patients with normal EF (EF ≥ 50%) [127]. Therefore, there were no correlations between sST2 levels and NT-proBNP concentration and parameters of AS severity [128].…”

Section: Biomarkersmentioning

confidence: 85%

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

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Berezin

Paar

et al. 2022

JPM

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Patients with severe aortic valve stenosis and concomitant pulmonary hypertension show a significantly reduced survival prognosis. Right heart catheterization as a preoperative diagnostic tool to determine pulmonary hypertension has been largely abandoned in recent years in favor of echocardiographic criteria. Clinically, determination of echocardiographically estimated systolic pulmonary artery pressure falls far short of invasive right heart catheterization data in terms of accuracy. The aim of the present systematic review was to highlight noninvasive possibilities for the detection of pulmonary hypertension in patients with severe aortic valve stenosis, with a special focus on cardiovascular biomarkers. A total of 525 publications regarding echocardiography, cardiovascular imaging and biomarkers related to severe aortic valve stenosis and pulmonary hypertension were analyzed in a systematic database analysis using PubMed Central®. Finally, 39 publications were included in the following review. It was shown that the current scientific data situation, especially regarding cardiovascular biomarkers as non-invasive diagnostic tools for the determination of pulmonary hypertension in severe aortic valve stenosis patients, is poor. Thus, there is a great scientific potential to combine different biomarkers (biomarker scores) in a non-invasive way to determine the presence or absence of PH.

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Section: Biomarkersmentioning

confidence: 85%

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Boxhammer

Berezin

Paar

et al. 2022

JPM

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“…Based on these limitations, more novel biomarkers are being studied to assess HF conditions, including sST2, GDF15, and IL-6. In the present study, we chose sST2 as a novel biomarker that contributes to the formation of myocardial fibrosis and ventricular remodeling [14,[21][22][23][30][31][32][33]. Since its discovery in 1989, increasing studies have confirmed that cardiomyocytes and cardiac fibroblasts induce release of both lST2 and sST2 when subjected to mechanical stretching in HF patients and in animal models.…”

Section: Discussionmentioning

confidence: 99%

“…Since its discovery in 1989, increasing studies have confirmed that cardiomyocytes and cardiac fibroblasts induce release of both lST2 and sST2 when subjected to mechanical stretching in HF patients and in animal models. e predictive value of sST2 among HF patients has been revealed in several studies [12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Interestingly, our best cutoff point of sST2 as a long-term mortality predictor in this study was 43.42671 ng/ml, which is greater than the traditional cutoff level of 35 ng/ml, possibly due to the additional protection of ICD therapy along with optimal medication, in these high-risk heart failure patients.…”

Section: Discussionmentioning

confidence: 99%

“…Originally, elevated levels of sST2 were reported to be associated with the severity of adverse cardiac remodeling and tissue fibrosis in HF patients. Further, increased levels of sST2 are correlated with more severe clinical symptoms and with other objective measures of HF severity such as higher C-reactive protein, higher natriuretic peptide levels, lower left ventricular ejection fraction (LVEF), and higher diastolic filling pressure [12,14,[19][20][21][22][23]. Using a nested case-control analysis of patients with ambulatory HF, Bayes-Genis and Giuseppe et al showed a significant correlation between elevated sST2 concentrations and risk of SCD [13,24].…”

Section: Introductionmentioning

confidence: 99%

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Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator

Hou¹,

Yu²,

Gao³

et al. 2020

Cardiology Research and Practice

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Background. Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac device implantation. Growth stimulation expressed gene 2 (ST2) is an emerging biomarker for HF patient stratification in different clinical settings. Aims. This study aimed to investigate the relationship between baseline soluble ST2 (sST2) levels in serum and the clinical outcomes of high-risk HF patients with device implantation. Methods. Between January 2017 and August 2018, we prospectively recruited consecutive patients implanted with an ICD for heart failure, with LVEF ≤35% as recommended, and analyzed the basic characteristics, baseline serum sST2, and NT-proBNP levels, with at least 1-year follow-up. All-cause mortality was the primary endpoint. Results. During a 643-day follow-up, all-cause mortality occurred in 16 of 150 patients (10.67%). Incidence of all-cause mortality increased significantly in patients with sST2 levels above 34.98846 ng/ml (16.00% vs. 5.33%, P = 0.034 ). After adjusting the model (age, gender, device implantation, prevention of sudden death, LVEDD, LVEF, WBC and CLBBB, hsTNT, etiology, and eGFR) and the model combined with NT-proBNP, the risk of all-cause death was increased by 2.5% and 1.9%, respectively, per ng/ml of sST2. The best sST2 cutoff for predicting all-cause death was 43.42671 ng/ml (area under the curve: 0.72, sensitive: 0.69, and specificity: 0.69). Compared to patients with sST2 levels below 43.42671 ng/ml, the risk of all-cause mortality was higher in those with values above the threshold (5.1% vs. 21.2%, P = 0.002 ). ST2 level ≥43.42671 ng/ml was an independent predictor of all-cause mortality (HR: 3.30 [95% CI 1.02–10.67]). Age (HR: 1.06 [95% CI: 1.01–1.12]) and increased NT-proBNP per 100 (HR: 1.02 [95% CI: 1.01–1.03]) were also associated with all-cause mortality in ICD patients. Conclusions. sST2 level was associated with risk of all-cause mortality, and a threshold of 43.43 ng/ml showed good distinguishing performance to predict all-cause mortality in patients with severe heart failure, recommended for ICD implantation. Patients with sST2 levels more than 43.42671 ng/ml even after ICD implantation should therefore be monitored carefully.

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“…ST2 is a receptor of the IL‐33 and consists of two common subtypes: sST2 and ST2L. ST2L is the specific IL‐33 receptor and is mainly expressed on the Th2 and mast cells, whereas the sST2 is the decoy receptor that negatively regulates the IL‐33/ST2 pathway 10–13 …”

Section: Introductionmentioning

confidence: 99%

IL‐33/ST2 pathway as upper‐hand of inflammation in allergic asthma contributes as predictive biomarker in heart failure

et al. 2022

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Allergic asthma is an inflammatory disorder of the bronchi, and as a major health problem, more than 350 million people suffer from asthma in the world. Many cardiovascular disorders resulted in the impairment of the heart's power to pump blood that leads to the HF. More than 25 million people worldwide live with HF. Accordingly, identifying the biomarkers to predict the onset of future asthma and HF is necessary. IL‐33 is an inflammatory cytokine that has the main role in pathophysiology of asthma and HF. Also, in IL‐33 receptor, the ST2 is involved in cardiac fibrosis and remodelling in HF and pathogenesis of allergic asthma. Increased sST2 in allergic asthma helps to control inflammation during asthma, but increased sST2 in HF is a predictable biomarker to present risk factor of HF during the time of the patients.

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ST2 in patients with severe aortic stenosis and heart failure

Cited by 13 publications

References 15 publications

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator

IL‐33/ST2 pathway as upper‐hand of inflammation in allergic asthma contributes as predictive biomarker in heart failure

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