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Diagnostic efficacy of soluble ST2 in pediatric fulminant myocarditis
YanZhu Huang1, YiHu Lin2, MingHong Fu3
1Department of Pediatric Neurology, Quanzhou Women and Children's Hospital, Fujian, China.
Insights
Soluble ST2 (sST2) shows high sensitivity and specificity for early identification of fulminant myocarditis (FM) in children. This biomarker can significantly aid in diagnosing pediatric FM, improving patient outcomes.
Area of Science:
- Pediatric Cardiology
- Biomarker Discovery
- Critical Care Medicine
Background:
- Fulminant myocarditis (FM) presents a high mortality risk in children.
- Effective biomarkers for early FM diagnosis are currently lacking.
- Timely identification of FM is crucial for reducing mortality rates.
Purpose of the Study:
- To evaluate the diagnostic value of soluble ST2 (sST2) in identifying pediatric FM.
- To compare the efficacy of sST2 with existing biomarkers for FM diagnosis.
Main Methods:
- A single-center observational study enrolled 144 children under 14 with viral myocarditis.
- Sixty-three children were diagnosed with FM.
- Levels of sST2, TNI, NT-proBNP, and CRP were measured and analyzed.
Main Results:
- Children with FM exhibited significantly higher sST2 levels compared to non-FM patients (104.40 vs. 38.30 ng/ml, p < 0.001).
- sST2 demonstrated optimal cut-off value of 63.8 ng/ml with 84.13% sensitivity and 88.9% specificity for FM.
- sST2 and NT-proBNP were identified as independent predictors of pediatric FM.
Conclusions:
- Soluble ST2 (sST2) is a highly sensitive and specific biomarker for the early detection of pediatric fulminant myocarditis.
- sST2 holds significant potential as a strong predictor in diagnosing FM in pediatric populations.
- Further research can explore therapeutic implications based on sST2 levels.
Background And Aims:
Early identification of fulminant myocarditis (FM) is the key to reducing mortality, but there is still a lack of effective biomarkers for diagnosis. The aim of this study was to investigate the value of soluble ST2 (sST2) in identifying FM in children.
Methods:
This was a single-center clinical observational study. We consecutively enrolled 144 children younger than 14 years of age diagnosed with viral myocarditis between January 2018 and November 2023, of whom 63 were diagnosed with FM.
Results:
The sST2 level in the FM group was significantly higher than that in the non-FM group [104.40 (68.80, 150.10) vs. 38.30 (19.85, 55.05), p < 0.001]. ROC curves showed that the optimal cut-off values of sST2, TNI, NT-proBNP and CRP for FM were 63.8 ng/ml, 13.3 ng/ml, 3182 pg/ml and 26.5 mg/L, respectively. The sensitivity and specificity of sST2 were 84.13% and 88.9%, indicating the highest early diagnosis efficiency. Multifactorial correction showed that sST2 ≥ 63.8 ng/ml and NT-proBNP ≥ 3182 pg/ml were independent diagnostic predictors of FM (OR = 22.374, 95% CI: 8.140 ∼ 61.499, P < 0.001), and (OR = 3.208, 95% CI: 1.163 ∼ 8.846, P = 0.024).
Conclusions:
With high sensitivity and specificity, sST2 may serve as a strong predictor of pediatric FM.
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