可溶性生长刺激表达基因2水平和三维斑点追踪作为慢性冠状动脉综合征中冠状动脉疾病严重程度的预测指标
sST2 levels and 3D speckle tracking as predictors of CAD severity in chronic coronary syndrome.
作者信息
Setouhi Amr, Maghraby K, Taha Nasser, Abdelsayed M, Hassan Mohammed H, Mahmoud Hossam Eldin M
机构信息
Department of Cardiology, Faculty of Medicine, Minia University, Minya, Egypt.
Cardiology Division of Internal Medicine Department, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
出版信息
Egypt Heart J. 2024 Dec 16;76(1):158. doi: 10.1186/s43044-024-00588-x.
BACKGROUND
Previous studies on the relation of sST2 with atherosclerotic disease mostly focused on the predictive value of sST2 for heart failure. However, there is no definite conclusion about the correlation between sST2 level and a complex coronary lesion morphology detected with coronary angiography (CAG). The purpose of this work was to know sST2 level and 3D speckle-tracking echocardiography as predictor of coronary artery disease (CAD) severity in chronic coronary syndrome (CCS) individuals using Gensini score. This prospective cohort work was performed on 90 participants aging from 18 to 80 years old, both sexes, with stable angina pectoris. Participants had been categorized into three groups: Group I (n = 30): control group scheduled by normal coronary angiography and group II (n = 60): case group which subdivided according to Gensini score into two equal subgroups: IIa: simple lesion (Gensini score < 20) and group IIb: complex lesion (Gensini score of ≥ 20). Plasma sST2 levels were measured in all participants using ELISA technique.
RESULTS
GLS, GAS, GCS and ST2 can significantly predict severity of CAD in CCS, respectively (P < 0.001 and AUC (95% CI) = 0.949(0.881-0.984), 0.980(0.925 to 0.998), 0.908(0.828 to 0.959) and 0.702(0.597 to 0.794)) at cutoff ≥ - 10, - 21, - 12 and ≥ 10 with 96.67% (82.8% to 99.9%), 96.67% (82.8 to 99.9), 86.67% (69.3 to 96.2) and 63.33% (43.9 to 80.1) sensitivity (95% CI), 76.67% (64.0% to 86.6%), 85.0% (73.4 to 92.9), 73.33% (60.3 to 83.9) and 65.0% (51.6 to 76.9) specificity (95% CI), 67.44%, 76.32%, 61.90% and 47.50% PPV and 97.87%, 98.08%, 91.67% and 78.00%, NPV with accuracy of 83.33%, 88.89%, 77.78% and 64.44%.
CONCLUSIONS
sST2 level, GLS, GAS and GCS can significantly predict severity of CAD in CCS.
背景
先前关于可溶性ST2（sST2）与动脉粥样硬化性疾病关系的研究大多集中于sST2对心力衰竭的预测价值。然而，关于sST2水平与通过冠状动脉造影（CAG）检测到的复杂冠状动脉病变形态之间的相关性尚无定论。本研究旨在了解使用Gensini评分时，sST2水平和三维斑点追踪超声心动图作为慢性冠状动脉综合征（CCS）患者冠状动脉疾病（CAD）严重程度预测指标的情况。这项前瞻性队列研究对90名年龄在18至80岁之间、患有稳定型心绞痛的男女参与者进行。参与者被分为三组：第一组（n = 30）：冠状动脉造影正常的对照组；第二组（n = 60）：病例组，根据Gensini评分分为两个相等的亚组：IIa：简单病变（Gensini评分<20）和IIb组：复杂病变（Gensini评分≥20）。使用酶联免疫吸附测定（ELISA）技术测量所有参与者的血浆sST2水平。
结果
整体纵向应变（GLS）、整体面积应变（GAS）、整体圆周应变（GCS）和sST2分别能显著预测CCS中CAD的严重程度（P < 0.001，曲线下面积[AUC，95%可信区间]分别为0.949[0.881 - 0.984]、0.980[0.925至0.998]、0.908[0.828至0.959]和0.702[0.597至0.794]），截断值分别为≥ - 10、 - 21、 - 12和≥10，敏感性（95%可信区间）分别为96.67%（82.8%至99.9%）、96.67%（82.8至99.9）、86.67%（69.3至96.2）和63.33%（43.9至80.1），特异性（95%可信区间）分别为76.67%（64.0%至86.6%）、85.0%（73.4至92.9）、73.33%（60.3至83.9）和65.0%（51.6至76.9），阳性预测值（PPV）分别为67.44%、76.32%、61.90%和47.50%，阴性预测值（NPV）分别为97.87%、98.08%、91.67%和78.00%，准确率分别为83.33%、88.89%、77.78%和64.44%。
结论
sST2水平、GLS、GAS和GCS能显著预测CCS中CAD的严重程度。
Zotero 插件