[Clinical application value of sST2 in patients with heart failure]

Accurate diagnosis and prognostic assessment of heart failure are crucial for improving patients' quality of life. This study aims to investigate the clinical value of serum soluble growth stimulation expressed gene 2 protein (sST2) levels in patients with heart failure, with and without obesity/overweight.

Serum samples were collected from patients with heart failure admitted to the Second Xiangya Hospital, Central South University, between October 2023 and March 2024. Participants were divided into three groups: heart failure with obesity/overweight group (n=71), heart failure without obesity/overweight group (n=62), and healthy control group (n=60). Serum sST2 levels were measured using a dry fluorescence immunoassay. Differences in sST2 concentrations among groups were analyzed, and the clinical value of sST2 and related metabolic indicators in different subgroups of patients with heart failure was evaluated.

Serum levels of sST2, N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and blood glucose (GLU) were significantly higher in patients with heart failure than in healthy controls, whereas total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were significantly lower (all P<0.05). Serum sST2 levels were significantly positively correlated with NT-proBNP, cTnT, GLU, and tricuspid regurgitation velocity (TRV), and significantly negatively correlated with HDL-C and left ventricular ejection fraction (LVEF) (all P<0.05). The diagnostic value of sST2 for heart failure was significantly higher in patients without obesity/overweight than in those with obesity/overweight [area under the curve (AUC): 0.803 vs 0.696]. sST2 demonstrated good diagnostic performance in patients with heart failure with reduced ejection fraction (HFrEF; LVEF≤40%) (AUC=0.807) and in patients without overweight or obesity with HFrEF (AUC=0.802) (both P<0.001). The combined use of sST2, body mass index (BMI), HDL-C, and age significantly improved the diagnostic performance for HF (AUC=0.983).

sST2 has substantial diagnostic value in patients with heart failure without overweight or obesity, but limited value in patients with overweight or obesity. Combined assessment of sST2, age, BMI, and HDL-C significantly enhances its diagnostic utility for heart failure. This model may be applicable for rapid heart failure screening in primary healthcare settings; however, prospective studies are required for further validation.