Serial sST2 dynamics after transcatheter tricuspid valve intervention: a candidate biomarker of biological response
Christoph Edlinger1,2,3, Johannes Schlegl1,2, Marwin Bannehr1,2
1Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau bei Berin, Germany.
Aims:
Patients undergoing transcatheter tricuspid valve intervention (TTVI) frequently present with advanced right-sided heart failure and multiorgan dysfunction, limiting the interpretability of conventional biomarkers such as natriuretic peptides. Soluble suppression of tumorigenicity 2 (sST2), a marker of myocardial strain, inflammation, and fibrosis, may provide complementary insight into biological response following intervention.
Patients & Methods:
In this prospective single-center cohort study, 135 patients undergoing TTVI were included. Plasma concentrations of sST2 were measured at baseline, discharge, 3 months, and 12 months. Longitudinal changes were analyzed using non-parametric repeated measures testing and compared with established biomarkers, including GDF-15, suPAR, H-FABP, NT-proANP and supplementary NT-proBNP analyses.
Results:
sST2 demonstrated a distinct biphasic trajectory, with an early increase at discharge followed by a significant decline at 3 and 12 months below baseline levels (overall p < 0.001). This pattern remained consistent in sensitivity analyses. In contrast, GDF-15, suPAR, H-FABP, NT-proANP, and supplementary NT-proBNP analyses showed heterogeneous longitudinal profiles without the sustained treatment-related trajectory observed for sST2.
Conclusions:
In patients undergoing TTVI, sST2 exhibits a characteristic longitudinal profile reflecting biological response to intervention. These findings identify sST2 as a candidate dynamic biomarker and support a framework distinguishing prognostic baseline-risk biomarkers from dynamic treatment-response biomarkers.
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