Cardiovascular Translational Research, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
Cardiovascular Translational Research, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
Rev Esp Cardiol (Engl Ed). 2023 Sep;76(9):679-689. doi: 10.1016/j.rec.2022.12.007. Epub 2022 Dec 21.
Patients with aortic stenosis (AS) exhibit left ventricular (LV) remodeling and replacement myocardial fibrosis (RMF). Whether sST2 is associated with RMF measured by cardiac magnetic resonance and with sex remains unknown.
We recruited 79 consecutive patients (73.0 [68.0-78.0] years; 61% men) with severe isolated AS underdoing valve replacement. RMF was identified and quantified by late gadolinium enhancement (LGE). Serum sST2 levels were determined.
RMF was associated with higher circulating sST2 levels, LV hypertrophy and dilation, and lower LV ejection fraction. All patients with LV dysfunction had RMF. Circulating levels of sST2 ≥ 28.8 ng/mL were associated with RMF and greater LV hypertrophy. LGE mass was correlated with LV remodeling and sST2. Of note, sST2 levels were also associated with the RMF pattern, being higher in midwall than in subendocardial fibrosis. Multivariate analyses showed that only LV ejection fraction and sST2 levels were associated with RMF. Moreover, men had higher levels of sST2 and RMF. RMF was associated with higher LV dilation and hypertrophy only in men and was correlated with LGE mass.
SST2 was an independent factor for RMF in patients with severe isolated AS. The presence of RMF was predicted by sST2 ≥ 28.2 ng/mL, and was associated with greater LV hypertrophy. sST2 expression and clinical associations may be sex-specific.
主动脉瓣狭窄（AS）患者表现出左心室（LV）重构和替代心肌纤维化（RMF）。可溶性生长刺激表达基因 2 蛋白（sST2）是否与心脏磁共振测量的 RMF 以及性别有关尚不清楚。
我们招募了 79 例连续接受瓣膜置换术的严重孤立性 AS 患者（73.0[68.0-78.0]岁；61%为男性）。通过晚期钆增强（LGE）确定和量化 RMF。测定血清 sST2 水平。
RMF 与较高的循环 sST2 水平、LV 肥厚和扩张以及较低的 LV 射血分数相关。所有 LV 功能障碍患者均有 RMF。循环 sST2 水平≥28.8ng/ml 与 RMF 和更大的 LV 肥厚相关。LGE 质量与 LV 重构和 sST2 相关。值得注意的是，sST2 水平也与 RMF 模式相关，中层壁纤维化的 sST2 水平高于心内膜下纤维化。多变量分析表明，只有 LV 射血分数和 sST2 水平与 RMF 相关。此外，男性的 sST2 和 RMF 水平更高。仅在男性中，RMF 与更高的 LV 扩张和肥厚相关，与 LGE 质量相关。
sST2 是严重孤立性 AS 患者 RMF 的独立因素。RMF 的存在可以通过 sST2≥28.2ng/ml 来预测，并与更大的 LV 肥厚相关。sST2 的表达和临床相关性可能具有性别特异性。
