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维持性血液透析患者可溶性 ST2 与左心室构型的关系。

Relationship between Soluble ST2 and Left Ventricular Geometry in Maintenance Hemodialysis Patients.

机构信息

Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.

Shanghai Municipal Health Commission, Shanghai Clinical Medical Center of Kidney Disease, Shanghai, China.

出版信息

Blood Purif. 2021;50(1):84-92. doi: 10.1159/000508402. Epub 2020 Dec 8.

Abstract

INTRODUCTION

Left ventricular hypertrophy (LVH) is a highly prevalent presentation of cardiac structural abnormality and a strong predictor of adverse outcomes in maintenance hemodialysis (MHD) patients. Different left ventricular geometry may provide additional clinical information. Soluble ST2 is a novel cardiac prognostic biomarker in MHD patients and is closely related to cardiac remodeling.

OBJECTIVE

This study sought to evaluate the association of sST2 and left ventricular structure in a cohort of MHD patients.

METHODS

Two hundred eighty-seven patients were enrolled. Left ventricular structure was assessed via transthoracic echocardiography. Left ventricular geometric patterns were defined according to left ventricular mass index and relative wall thickness (RWT). Serum sST2 levels were measured.

RESULTS

Prevalence of LVH was 44.9% in the study population. In univariate analysis, sST2 levels were correlated with interventricular septal wall thickness, posterior wall thickness, and RWT. After multivariate adjustment, sST2 was independently correlated with only RWT (p = 0.028). Comparing sST2 concentrations across different LV geometric patterns, we found sST2 levels were significantly increased in patients with concentric cardiac remodeling and concentric LVH.

CONCLUSIONS

The present study found that sST2 were significantly increased in patients with concentric remodeling and concentric LVH. ST2/interleukin (IL)-33 signaling might participate in the process of cardiac remodeling via its pro-fibrotic action. Future studies on the mechanism of ST2/IL-33 pathway are needed.

摘要

简介

左心室肥厚(LVH)是心脏结构异常的一种高度普遍的表现,也是维持性血液透析(MHD)患者不良预后的强有力预测因素。不同的左心室几何形状可能提供额外的临床信息。可溶性 ST2 是 MHD 患者的一种新型心脏预后生物标志物,与心脏重构密切相关。

目的

本研究旨在评估可溶性 ST2(sST2)与 MHD 患者左心室结构之间的关系。

方法

共纳入 287 例患者。通过经胸超声心动图评估左心室结构。根据左心室质量指数和相对室壁厚度(RWT)定义左心室几何形态。测量血清 sST2 水平。

结果

研究人群中 LVH 的患病率为 44.9%。在单因素分析中,sST2 水平与室间隔壁厚度、后壁厚度和 RWT 相关。经过多变量调整后,sST2 仅与 RWT 独立相关(p=0.028)。比较不同左心室几何形态的 sST2 浓度,我们发现向心性重构和向心性 LVH 患者的 sST2 水平显著升高。

结论

本研究发现,向心性重构和向心性 LVH 患者的 sST2 水平显著升高。ST2/白细胞介素(IL)-33 信号可能通过其促纤维化作用参与心脏重构过程。需要进一步研究 ST2/IL-33 通路的机制。

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