Banaszkiewicz Marta, Pietrasik Arkadiusz, Darocha Szymon, Piłka Michał, Florczyk Michał, Dobosiewicz Anna, Kędzierski Piotr, Pędzich-Placha Ewa, Kochman Janusz, Opolski Grzegorz, Torbicki Adam, Kurzyna Marcin
Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock, Poland.
First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Arch Med Sci. 2020 Sep 3;20(5):1442-1451. doi: 10.5114/aoms.2020.98635. eCollection 2024.
Non-invasive tests that may improve clinical evaluation of pulmonary hypertension (PH) are needed. The purpose of this study was to assess the role of soluble ST2 (sST2) in patients with PH.
A total of 57 patients with chronic thromboembolic PH and 43 patients with idiopathic arterial PH were enrolled in this study. All patients were evaluated for World Health Organization (WHO) functional class (FC), -terminal prohormone B-type natriuretic peptide (NT-proBNP), troponin T (TnT), and hemodynamics. Plasma sST2 was assessed by an immunofluorescent diagnostic assay. All patients were followed up from the date of blood sampling. The endpoint was all-cause death.
The median sST2 concentration was 32.8 ng/ml (IQR: 21.6-48.5 ng/ml) in the whole study population. Significant differences were found between median sST2 in successive WHO FCs (FC II vs. FC III, = 0.002; FC III vs. FC IV, = 0.12; FC II vs. FC IV, = 0.008). Significant correlations were found between sST2 and hemodynamic parameters: mean right atrial pressure ( = 0.56; < 0.05), mean pulmonary artery pressure ( = 0.25; < 0.05), cardiac index ( = -0.40; < 0.05), pulmonary vascular resistance ( = 0.41; < 0.05), and between sST2 and WHO FC ( = 0.36; < 0.05), NT-proBNP ( = 0.55; < 0.05), and TnT ( = 0.44; < 0.05). sST2 concentration above the median was associated with worse clinical prognosis ( = 0.02, Kaplan-Meier).
sST2 seems to be a marker of poor clinical prognosis in patients with PH.
需要能够改善肺动脉高压（PH）临床评估的非侵入性检测方法。本研究的目的是评估可溶性ST2（sST2）在PH患者中的作用。
本研究共纳入57例慢性血栓栓塞性PH患者和43例特发性动脉性PH患者。所有患者均接受了世界卫生组织（WHO）功能分级（FC）、N末端B型利钠肽原（NT-proBNP）、肌钙蛋白T（TnT）和血流动力学评估。采用免疫荧光诊断法评估血浆sST2。所有患者从采血之日起进行随访。终点为全因死亡。
整个研究人群中sST2浓度的中位数为32.8 ng/ml（四分位间距：21.6 - 48.5 ng/ml）。连续WHO功能分级中的sST2中位数之间存在显著差异（FC II与FC III相比，P = 0.002；FC III与FC IV相比，P = 0.12；FC II与FC IV相比，P = 0.008）。sST2与血流动力学参数之间存在显著相关性：平均右心房压（r = 0.56；P < 0.05）、平均肺动脉压（r = 0.25；P < 0.05）、心脏指数（r = -0.40；P < 0.05）、肺血管阻力（r = 0.41；P < 0.05），并且sST2与WHO功能分级（r = 0.36；P < 0.05）、NT-proBNP（r = 0.55；P < 0.05）和TnT（r = 0.44；P < 0.05）之间也存在显著相关性。sST2浓度高于中位数与较差的临床预后相关（P = 0.02，Kaplan-Meier）。
sST2似乎是PH患者临床预后不良的一个标志物。
