Yan Xianliang, Guo Yanqing, Li Li, Wang Zhixin, Li Zhizhong
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Chaoyang, Beijing, China.
Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, China.
J Thorac Dis. 2022 May;14(5):1578-1587. doi: 10.21037/jtd-22-470.
Most heart failure (HF) patients were complicated with atrial fibrillation (AF). Previous study has reported a correlation between soluble suppression of tumorigenicity 2 (sST2) and HF. While the association between sST2 and AF in HF patients remains elusive, which will strengthen our understanding of sST2 in HF patients.
In the study, a case-control study was conducted with 306 HF patients enrolled from June 2019 to June 2020 at Beijing Anzhen Hospital. All the patients were divided into the following two groups, based on whether they AF complications prior to admission: (I) the HF group (patients with HF alone) and the HF-AF group (HF patients complicated with AF). Baseline data and sST2 levels were assessed and compared between the two groups, and the influencing factors associated with AF in HF patients were screened.
The sST2 level in the HF-AF group was 40.6 (25.9-53.6) ng/mL, which was significantly higher than that in the HF group [23.7 (16.3-35.9) ng/mL] (P<0.001). Correlation analysis showed that sST2 level in the HF-AF group was positively correlated with age (r=0.287, P=0.001), New York Heart Association (NYHA) grade (r=0.470, P<0.0001), left ventricular diameter (LVD) (r=0.311, P=0.001), serum creatinine (r=0.320, P<0.0001), NT-pro-brain natriuretic peptide (r=0.540, P<0.0001), and D-dimer (r=0.322, P<0.0001), and negatively correlated with left ventricular ejection fraction (LVEF) (r=-0.259, P=0.004), hemoglobin (r=-0.188, P=0.039), and glomerular filtration rate (r=-0.283, P=0.002). Logistic regression analysis results indicated that history of coronary heart disease [odds ratio (OR): 0.176, 95% confidence interval (CI): 0.081-0.380, P<0.0001], LVEF (OR: 0.956, 95% CI: 0.915-0.998, P=0.039), LVD (OR: 1.156, 95% CI: 1.059-1.261, P=0.001), left arterial diameter (OR: 0.761, 95% CI: 0.695-0.833, P<0.0001), and sST2 (OR: 0.942, 95% CI: 0.917-0.967, P<0.0001) were independent influencing factors associated with AF in HF patients.
The sST2 level is an independent influencing factor associated with AF in HF patients, which may favor to optimize the clinical strategies in the management of HF patients complicated with AF.
大多数心力衰竭（HF）患者合并心房颤动（AF）。既往研究报道了可溶性肿瘤生长抑制因子2（sST2）与HF之间的相关性。然而，HF患者中sST2与AF之间的关联仍不明确，这将加深我们对HF患者中sST2的理解。
本研究为病例对照研究，纳入了2019年6月至2020年6月在北京安贞医院就诊的306例HF患者。根据入院前是否有AF并发症，将所有患者分为以下两组：（I）HF组（仅患有HF的患者）和HF-AF组（合并AF的HF患者）。评估并比较两组患者的基线数据和sST2水平，筛选出与HF患者AF相关的影响因素。
HF-AF组的sST2水平为40.6（25.9-53.6）ng/mL，显著高于HF组[23.7（16.3-35.9）ng/mL]（P<0.001）。相关性分析显示，HF-AF组的sST2水平与年龄（r=0.287，P=0.001）、纽约心脏协会（NYHA）分级（r=0.470，P<0.0001）、左心室直径（LVD）（r=0.311，P=0.001）、血清肌酐（r=0.320，P<0.0001）、N末端脑钠肽前体（r=0.540，P<0.0001）和D-二聚体（r=0.322，P<0.0001）呈正相关，与左心室射血分数（LVEF）（r=-0.259，P=0.004）、血红蛋白（r=-0.188，P=0.039）和肾小球滤过率（r=-0.283，P=0.002）呈负相关。Logistic回归分析结果表明，冠心病史[比值比（OR）：0.176，95%置信区间（CI）：0.081-0.380，P<0.0001]、LVEF（OR：0.956，95%CI：0.915-0.998，P=0.039）、LVD（OR：1.156，95%CI：1.059-1.261，P=0.001）、左动脉直径（OR：0.761，95%CI：0.695-0.833，P<0.0001）和sST2（OR：0.942，95%CI：0.917-0.967，P<0.0001）是HF患者AF的独立影响因素。
sST2水平是HF患者AF的独立影响因素，这可能有助于优化合并AF的HF患者的临床管理策略。
