Soluble ST2 as a Potential Biomarker for Risk Assessment of Pulmonary Hypertension in Patients Undergoing TAVR?

可溶性 ST2 是否可以作为 TAVR 患者肺动脉高压风险评估的潜在生物标志物?

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作者:Elke Boxhammer, Moritz Mirna, Laura Bäz, Nina Bacher, Albert Topf, Brigitte Sipos, Marcus Franz, Daniel Kretzschmar, Uta C Hoppe, Alexander Lauten, Michael Lichtenauer

Background

Severe aortic valve stenosis (AS) is associated with pulmonary hypertension (PH) and has been shown to limit patient survival. Soluble suppression of tumorigenicity-2 (sST2) is a cardiovascular biomarker that has proven to be an important prognostic marker for survival in patients undergoing transcatheter aortic valve replacement (TAVR). The

Conclusion

sST2 definitely has the potential to provide information about the presence of PH in patients with severe AS, in a noninvasive way.

Methods

In 260 patients with severe AS undergoing TAVR procedure, sST2 serum level concentrations were analyzed. Right heart catheter measurements were performed in 152 patients, with no PH detection in 43 patients and with PH detection in 109 patients. Correlation analyses according to Spearman, AUROC analyses and Kaplan-Meier curves were calculated.

Results

Patients with severe AS and PH showed significantly higher serum sST2 concentrations (p = 0.006). The sST2 cut-off value for non-PH patients regarding 1-year survival yielded 5521.15 pg/mL, whereas the cut-off value of PH patients was at a considerably higher level of 10,268.78 pg/mL. A cut-off value of 6990.12 pg/mL was related with a significant probability of PH presence. Survival curves showed that patients with severe AS and PH not only had higher 1-year mortality, but also that increased levels of sST2 plasma concentration were associated with earlier death.

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