Luo N S, Zhang H F, Liu P M, Lin Y Q, Huang T C, Yang Y, Wang J F
Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou 510120, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2017 Mar 24;45(3):198-203. doi: 10.3760/cma.j.issn.0253-3758.2017.03.006.
Diagnostic efficacy of serum markers is low for heart failure patients with preserved left ventricular ejection fraction (HF-pEF) as compared to heart failure patients with reduced left ventricular ejection fraction.We sought to explore the diagnostic value of serum levels of soluble ST2 (sST2) combined with interleukin-33 (IL-33) for the diagnosis of HF-pEF in this study. A total of 376 patients with HF-pEF (HF group), 376 matched-control patients without heart failure who shared similar clinical characteristics (non-HF group) were included in the study.Another 500 healthy individuals were recruited for assessing the normal ranges of IL-33 and sST2.Serum levels of NT-proBNP were measured by chemi-luminescence assay, while IL-33 and sST2 were measured by enzyme linked immunosorbent assay. Serum levels of IL-33 and sST2 were not normally distributed in healthy population.Serum concentrations of IL-33 and sST2 were significantly higher in HF-pEF patients than in patients in non-HF group (median, IL-33: 0.437 μg/L vs. 0.127 μg/L, <0.01; sST: 0.118 μg/L vs. 0.067 μg/L, <0.01). The area under receiver operating characteristic curve (AUC) of sST2 for detecting HF-pEF was 0.763 (95% 0.729-0.795, <0.01), with 71.01% sensitivity and 66.75% specificity, the AUC was 0.884 (95% 0.859-0.908, <0.01), with 80.05% sensitivity and 81.91% specificity in patients with serum IL-33 higher than 0.117 μg/L (median level of serum IL-33 in healthy individuals, =306). The AUC of NT-proBNP for detecting HF-pEF was 0.83, with 74.73% sensitivity and 84.57% specificity.The AUC of sST2 for detecting HF-pEF was significantly higher than NT-proBNP in population with high serum IL-33 (AUC: 0.88 vs. 0.83, <0.01). Serum sST2 could serve as a satisfactory biomarker for HF-pEF diagnosis, especially for patients with high serum IL-33 concentrations.
与左心室射血分数降低的心力衰竭患者相比，血清标志物对左心室射血分数保留的心力衰竭患者（HF-pEF）的诊断效能较低。在本研究中，我们试图探讨可溶性ST2（sST2）联合白细胞介素-33（IL-33）的血清水平对HF-pEF的诊断价值。该研究共纳入了376例HF-pEF患者（HF组）以及376例临床特征相似的无心力衰竭匹配对照患者（非HF组）。另外招募了500名健康个体以评估IL-33和sST2的正常范围。采用化学发光法测定NT-proBNP的血清水平，采用酶联免疫吸附测定法测定IL-33和sST2。健康人群中IL-33和sST2的血清水平呈非正态分布。HF-pEF患者的IL-33和sST2血清浓度显著高于非HF组患者（中位数，IL-33：0.437μg/L对0.127μg/L，<0.01；sST：0.118μg/L对0.067μg/L，<0.01）。sST2检测HF-pEF的受试者工作特征曲线下面积（AUC）为0.763（95% 0.729 - 0.795，<0.01），敏感性为71.01%，特异性为66.75%；在血清IL-33高于0.117μg/L（健康个体血清IL-33中位数水平，=306）的患者中，AUC为0.884（95% 0.859 - 0.908，<0.01），敏感性为80.05%，特异性为81.91%。NT-proBNP检测HF-pEF的AUC为0.83，敏感性为74.73%，特异性为84.57%。在血清IL-33水平较高的人群中，sST2检测HF-pEF的AUC显著高于NT-proBNP（AUC：0.88对0.83，<0.01）。血清sST2可作为HF-pEF诊断的良好生物标志物，尤其是对于血清IL-33浓度较高的患者。
