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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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ST2 in heart failure with preserved and reduced ejection fraction
Emil Najjar1,2, Ulrika Ljung Faxén1,3, Camilla Hage1,2
1a Department of Medicine , Karolinska Institutet , Stockholm , Sweden.
Scandinavian Cardiovascular Journal : SCJ
|February 20, 2019
Summary
Soluble suppression of tumorigenecity 2 (sST2) is a prognostic marker in heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Lower sST2 levels in HFpEF may indicate less fibrosis but a stronger association with outcomes.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Pathophysiology
Background:
- Soluble suppression of tumorigenecity 2 (sST2) is a known prognostic indicator in heart failure with reduced ejection fraction (HFrEF).
- Its role in heart failure with preserved ejection fraction (HFpEF) is less understood.
- This study investigates sST2 in both HFpEF and HFrEF populations.
Purpose of the Study:
- To evaluate sST2 concentrations in HFpEF and HFrEF.
- To assess correlations between sST2, biomarkers (NT-proBNP), and echocardiographic measures.
- To determine the association of sST2 with clinical outcomes in HFpEF and HFrEF.
Main Methods:
- Analysis of 193 subjects across three cohorts: HFpEF (n=86), HFrEF (n=86), and controls (n=21).
- Measurement of sST2 levels and NT-proBNP.
- Echocardiographic assessment of diastolic and systolic function.
- Survival analysis for composite endpoints (death, hospitalization, transplant, LVAD).
Main Results:
- sST2 levels were significantly lower in HFpEF (23 [17-31] µg/L) compared to HFrEF (35 [23-52] µg/L).
- sST2 positively correlated with NT-proBNP in both HFpEF and HFrEF.
- In HFpEF, sST2 correlated with left atrial volume index and was associated with increased risk of death or HF hospitalization (aHR 6.62).
- In HFrEF, sST2 was associated with increased risk of death, heart transplant, or LVAD (aHR 3.51).
Conclusions:
- sST2 is a prognostic marker in both HFpEF and HFrEF.
- Lower sST2 levels in HFpEF may suggest less fibrosis but potentially greater prognostic significance.
- These findings highlight the potential for sST2-targeted interventions in HFpEF.
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