ST2 pathogenetic profile in ambulatory heart failure patients
Antoni Bayes-Genis1, James L Januzzi2, Hanna K Gaggin2
1Heart Failure Unit, Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
Journal of Cardiac Failure
|December 3, 2014
Summary
Soluble ST2 is a valuable 3-in-1 prognosis biomarker for heart failure (HF). It offers significant long-term risk stratification beyond other HF biomarkers for strain, inflammation, and remodeling.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Pathophysiology
Background:
- Soluble ST2 (ST2) is implicated in cardiac strain, inflammation, and myocardial necrosis with remodeling.
- The prognostic impact of ST2 across varying degrees of these pathogenic pathways in heart failure (HF) remains unclear.
Purpose of the Study:
- To evaluate if soluble ST2 improves HF risk stratification compared to established biomarkers.
- To assess ST2's prognostic value in relation to biomarkers of cardiac strain, inflammation, necrosis, and remodeling.
Main Methods:
- Analysis of 1,015 HF patients with a mean left ventricular ejection fraction (LVEF) of 33.5%.
- Compared soluble ST2 levels with N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), galectin-3, and high-sensitivity troponin T (hsTnT).
- Mean follow-up of 4.2 years, assessing mortality risk.
Main Results:
- Soluble ST2 showed the highest correlation with NT-proBNP (r=0.32) and lowest with galectin-3 (r=0.15).
- ST2 levels significantly increased with higher concentrations of other biomarkers (P < .001).
- Soluble ST2 independently predicted risk across all tertiles of other biomarkers, even after clinical parameter adjustment.
Conclusions:
- Soluble ST2 functions as a comprehensive "3-in-1" prognostic biomarker in HF.
- ST2 provides crucial long-term risk stratification data in HF, augmenting information from other pathway-specific biomarkers.
More Related Videos
04:05Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
3.1K
09:05Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
20.4K
Related Concept Videos
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
813
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
813
01:30Acute Coronary Syndrome III: Diagnostic Studies
484
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
484
01:29Heart Failure II: Pathophysiology
1.6K
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.6K
01:17Pathophysiology of Heart Failure
4.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.8K
01:29Electrocardiogram
10.3K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
10.3K
01:30Acute Coronary Syndrome I: Introduction
1.9K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.9K