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可溶性 ST2 是与原发性高血压患者左心室肥厚和向心性肥厚相关的生物标志物。

Soluble ST2 Is a Biomarker Associated With Left Ventricular Hypertrophy and Concentric Hypertrophy in Patients With Essential Hypertension.

机构信息

Department of Cardiovascular, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Am J Hypertens. 2024 Nov 15;37(12):987-994. doi: 10.1093/ajh/hpae105.

Abstract

BACKGROUND

Elevated soluble stimulating factor 2 (sST2) level is observed in cardiovascular diseases, such as heart failure and acute coronary syndrome, which reflects myocardial fibrosis and hypertrophy, indicating adverse clinical outcomes. However, the association between sST2 and hypertensive heart disease are less understood. This study aimed to determine the relationship of sST2 with left ventricular hypertrophy (LVH) and geometric remodeling in essential hypertension (EH).

METHODS

We enrolled 483 patients (aged 18-80 years; 51.35% female). sST2 measurements and echocardiographic analyses were performed.

RESULTS

Stepwise multiple linear regression analysis showed significant associations among sST2, left ventricular (LV) mass, and LV mass index. The prevalence of LVH and concentric hypertrophy (CH) increased with higher sST2 grade levels (P for trend < 0.05). Logistic regression analysis suggested that the highest tertile of sST2 was significantly associated with increased LVH risk, compared with the lowest tertile (multivariate-adjusted odds ratio [OR] of highest group: 6.61; P < 0.001). Similar results were observed in the left ventricular geometric remodeling; the highest tertile of sST2 was significantly associated with increased CH risk (multivariate-adjusted OR of highest group: 5.80; P < 0.001). The receiver operating characteristic analysis results revealed that sST2 had potential predictive value for LVH (area under the curve [AUC]: 0.752, 95% confidence interval [CI]: 0.704-0.800) and CH (AUC: 0.750, 95% CI: 0.699-0.802) in patients with EH.

CONCLUSIONS

High sST2 level is strongly related to LVH and CH in patients with EH and can be used as a biomarker for the diagnosis and risk assessment of hypertensive heart disease.

CLINICAL TRIALS REGISTRATION

Trial Number ChiCTR2400082764.

摘要

背景

可溶性刺激因子 2(sST2)水平升高可见于心血管疾病,如心力衰竭和急性冠状动脉综合征,这反映了心肌纤维化和肥大,预示着不良的临床结局。然而,sST2 与高血压性心脏病的关系尚不清楚。本研究旨在确定 sST2 与原发性高血压(EH)患者左心室肥厚(LVH)和几何重构的关系。

方法

我们纳入了 483 名年龄在 18-80 岁的患者(51.35%为女性),进行了 sST2 测量和超声心动图分析。

结果

逐步多元线性回归分析显示 sST2 与左心室(LV)质量和 LV 质量指数之间存在显著相关性。随着 sST2 等级水平的升高,LVH 和向心性肥厚(CH)的患病率增加(趋势 P 值均<0.05)。Logistic 回归分析表明,与最低三分位组相比,sST2 最高三分位组与 LVH 风险增加显著相关(最高组的多变量校正比值比:6.61;P<0.001)。在左心室几何重构中也观察到了类似的结果;sST2 最高三分位组与 CH 风险增加显著相关(最高组的多变量校正比值比:5.80;P<0.001)。受试者工作特征分析结果表明,sST2 对 EH 患者的 LVH(曲线下面积 [AUC]:0.752,95%置信区间 [CI]:0.704-0.800)和 CH(AUC:0.750,95%CI:0.699-0.802)具有潜在的预测价值。

结论

高 sST2 水平与 EH 患者的 LVH 和 CH 密切相关,可作为诊断和评估高血压性心脏病风险的生物标志物。

临床试验注册

ChiCTR2400082764。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c94/11565189/5981ec98531d/hpae105_fig1.jpg

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