Yucel O, Gul I, Zararsiz A, Demirpence O, Yucel H, Cinar Z, Zorlu A, Yilmaz M B
Departments of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey.
Departments of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
Herz. 2018 Aug;43(5):455-460. doi: 10.1007/s00059-017-4590-1. Epub 2017 Jun 26.
Biomarkers play an important role in the risk stratification of patients with heart failure (HF). Recent studies have shown that soluble suppression of tumorigenicity 2 (sST2), a member of the interleukin 1 receptor family, is associated with disease prognosis in acute and chronic HF. In this study we aimed to investigate the relation between sST2 level and functional capacity in outpatients with systolic HF.
This study included 120 HF patients with reduced ejection fraction (HFrEF; EF ≤ 40%). The mean age of patients was 66 ± 11 years. Advanced HF (New York Heart Association [NYHA] functional class III-IV) was observed in 35 patients (29%).
sST2 levels were on average higher in patients with NYHA functional classes III and IV than in patients with NYHA functional classes I and II (51 [9-198] vs. 25 ng/ml [9-118], p < 0.001). In a multiple logistic regression model, sST2 level (OR: 1.044, p = 0.004, 95% CI: 1.014-1.075), hemoglobin level (OR: 0.590, p = 0.001, 95% CI: 0.433-0.805), total cholesterol level (OR: 0.977, p = 0.004, 95% CI: 0.962-0.993), and age (OR: 1.066, p = 0.047, 95% CI: 1.001-1.136) were associated with poor functional capacity. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of sST2 for predicting poor functional capacity was >42 ng/ml, with 63% sensitivity and 88% specificity (AUC: 0.810, 95% CI: 0.728- 0.875).
Higher sST2 levels were strongly associated with poor NYHA functional class, independent of cardiac risk factors, in outpatients with HFrEF.
生物标志物在心力衰竭（HF）患者的风险分层中起着重要作用。最近的研究表明，白细胞介素1受体家族成员可溶性肿瘤抑制因子2（sST2）与急慢性HF的疾病预后相关。在本研究中，我们旨在探讨收缩性HF门诊患者sST2水平与心功能的关系。
本研究纳入120例射血分数降低的HF患者（HFrEF；EF≤40%）。患者的平均年龄为66±11岁。35例患者（29%）出现晚期HF（纽约心脏协会[NYHA]心功能分级III-IV级）。
NYHA心功能分级III级和IV级患者的sST2水平平均高于NYHA心功能分级I级和II级患者（51[9-198]对25 ng/ml[9-118]，p<0.001）。在多因素逻辑回归模型中，sST2水平（OR：1.044，p=0.004，95%CI：1.014-1.075）、血红蛋白水平（OR：0.590，p=0.001，95%CI：0.433-0.805）、总胆固醇水平（OR：0.977，p=0.004，95%CI：0.962-0.993）和年龄（OR：1.066，p=0.047，95%CI：1.001-1.136）与心功能差相关。在受试者工作特征（ROC）曲线分析中，预测心功能差的sST2最佳截断值>42 ng/ml，敏感性为63%，特异性为88%（AUC：0.810，95%CI：0.728-0.875）。
在HFrEF门诊患者中，较高的sST2水平与NYHA心功能分级差密切相关，且独立于心脏危险因素。
