Alborikan S, Althunayyan A, Pandya B, Von Klemperer K, Walker F, Cullen S, Bhan A, Badiani S, Encarnacion D, Monteiro R, Petersen S E, Bhattacharyya S, Lloyd G
Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
William Harvey Research Institute, Queen Mary University of London, London, UK.
Int J Cardiol Congenit Heart Dis. 2023 Nov 3;14:100483. doi: 10.1016/j.ijcchd.2023.100483. eCollection 2023 Dec.
The relationship between plasma brain natriuretic peptide (NT-proBNP) and soluble suppression of tumorigenicity-2 (sST2) with structural adaptions and exercise capacity remains incompletely described in patients with repaired Tetralogy of Fallot (rTOF).
Peripheral venous blood samples were drawn for 99 patients with repaired TOF, 59 patients with severe pulmonary regurgitation (PR) and 40 patients with no or mild PR. NT-proBNP was measured using enzyme-linked immunosorbent assays (Roche Diagnostics, Indianapolis, IN). Soluble ST2 levels were assessed on Aspect-plus ST2 quantitative rapid test.
The mean value of NT-proBNP was 160 ± 137 pg/ml, and sST2 was 29 ± 13, ng/ml in the entire population. 58 % had an elevated NT-proBNP, while sST2 was abnormal in 40 %. Mean NT-proBNP was significantly higher in patients with severe PR (169 ± 150 vs145 ± 118, pg/ml, p < 0.001), while similar sST2 levels were observed in both groups (29 ± 14 vs30 ± 12, ng/ml, p > 0.05). NT-proBNP and sST2 levels were higher in patients with transannular patch when compared to other RVOT intervention (174 ± 145 vs 107 ± 100, pg/ml, p < 0.001); (31 ± 13 vs 29 ± 15, ng/ml, p < 0.05). Both biomarkers were significantly associated with exercise capacity, but NT-proBNP (r = -0.60, p < 0.001) was stronger. The optimal cut-off of 90 pg/ml for NT-proBNP had a sensitivity of 74 % and specificity of 63 % for detection of impaired exercise capacity.
Serum levels of sST2 and NT-proBNP are elevated in patients with repaired TOF, with higher values observed in those with severe PR, but also in patients undergoing transannular patch repair. Incorporating both markers in these patients increased the ability to detect impairment in exercise capacity.
在法洛四联症修复术（rTOF）患者中，血浆脑钠肽（NT-proBNP）和可溶性肿瘤生长抑制因子2（sST2）与结构适应性及运动能力之间的关系尚未完全阐明。
采集99例法洛四联症修复术患者、59例重度肺动脉反流（PR）患者和40例无或轻度PR患者的外周静脉血样本。采用酶联免疫吸附测定法（罗氏诊断公司，印第安纳波利斯，印第安纳州）检测NT-proBNP。使用Aspect-plus ST2定量快速检测法评估可溶性ST2水平。
整个人群中NT-proBNP的平均值为160±137 pg/ml，sST2为29±13 ng/ml。58%的患者NT-proBNP升高，40%的患者sST2异常。重度PR患者的平均NT-proBNP显著更高（169±150 vs 145±118，pg/ml，p<0.001），而两组的sST2水平相似（29±14 vs 30±12，ng/ml，p>0.05）。与其他右心室流出道干预措施相比，采用跨环补片的患者NT-proBNP和sST2水平更高（174±145 vs 107±100，pg/ml，p<0.001）；（31±13 vs 29±15，ng/ml，p<0.05）。两种生物标志物均与运动能力显著相关，但NT-proBNP（r=-0.60，p<0.001）的相关性更强。NT-proBNP的最佳截断值为90 pg/ml，检测运动能力受损的敏感性为74%，特异性为63%。
法洛四联症修复术患者的血清sST2和NT-proBNP水平升高，重度PR患者及接受跨环补片修复的患者水平更高。将这两种标志物纳入评估可提高检测运动能力受损的能力。
