Boxhammer Elke, Mirna Moritz, Bäz Laura, Bacher Nina, Topf Albert, Sipos Brigitte, Franz Marcus, Kretzschmar Daniel, Hoppe Uta C, Lauten Alexander, Lichtenauer Michael
Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria.
Department of Cardiology, Clinic of Internal Medicine I, Friedrich Schiller University Jena, 07743 Jena, Germany.
Life (Basel). 2022 Mar 8;12(3):389. doi: 10.3390/life12030389.
Severe aortic valve stenosis (AS) is associated with pulmonary hypertension (PH) and has been shown to limit patient survival. Soluble suppression of tumorigenicity-2 (sST2) is a cardiovascular biomarker that has proven to be an important prognostic marker for survival in patients undergoing transcatheter aortic valve replacement (TAVR). The aim of this study was to assess the importance of the sST2 biomarker for risk stratification in patients with severe AS in presence or absence of PH.
In 260 patients with severe AS undergoing TAVR procedure, sST2 serum level concentrations were analyzed. Right heart catheter measurements were performed in 152 patients, with no PH detection in 43 patients and with PH detection in 109 patients. Correlation analyses according to Spearman, AUROC analyses and Kaplan-Meier curves were calculated.
Patients with severe AS and PH showed significantly higher serum sST2 concentrations ( = 0.006). The sST2 cut-off value for non-PH patients regarding 1-year survival yielded 5521.15 pg/mL, whereas the cut-off value of PH patients was at a considerably higher level of 10,268.78 pg/mL. A cut-off value of 6990.12 pg/mL was related with a significant probability of PH presence. Survival curves showed that patients with severe AS and PH not only had higher 1-year mortality, but also that increased levels of sST2 plasma concentration were associated with earlier death.
sST2 definitely has the potential to provide information about the presence of PH in patients with severe AS, in a noninvasive way.
重度主动脉瓣狭窄（AS）与肺动脉高压（PH）相关，且已证实会限制患者生存。可溶性肿瘤抑制因子2（sST2）是一种心血管生物标志物，已被证明是经导管主动脉瓣置换术（TAVR）患者生存的重要预后标志物。本研究的目的是评估sST2生物标志物在有或无PH的重度AS患者风险分层中的重要性。
对260例接受TAVR手术的重度AS患者的sST2血清水平浓度进行分析。对152例患者进行了右心导管测量，其中43例未检测到PH，109例检测到PH。计算了Spearman相关性分析、AUROC分析和Kaplan-Meier曲线。
重度AS和PH患者的血清sST2浓度显著更高（ = 0.006）。非PH患者1年生存率的sST2临界值为5521.15 pg/mL，而PH患者的临界值则高得多，为10268.78 pg/mL。临界值6990.12 pg/mL与PH存在的显著概率相关。生存曲线显示，重度AS和PH患者不仅1年死亡率更高，而且sST2血浆浓度升高与更早死亡相关。
sST2肯定有潜力以非侵入性方式提供重度AS患者是否存在PH的信息。
