Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

Diagnostic Value of ST2 in Right Heart Failure

M. Natale1, M. Harbrücker1, S.-H. Kim1, S. Lindner1, S. Lang1, M. Borggrefe1, T. Roth2, T. Bertsch3, I. Akin1, M. Behnes1, für die Studiengruppe: CIBER

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Institut für Experimentelle u. Klinische Pharmakologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen; 3Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg;

Purpose: Right heart contributes to increased morbidity and mortality, even in leftheart failure with preserved ejection fraction. The novel biomarker ST2 mayreflect adverse cardiac remodeling and tissue fibrosis. This study aims to evaluatethe association between ST2 and right heart failure assessed by echocardiography. Methods: Patients undergoing routine transthoracic echocardiography wereprospectively enrolled in the present monocentric study. Patients with leftventricular dysfunction (LVEF <50 %) or moderate or severe aortic or mitralvalvular heart diseases were excluded. Blood samples for measurements of ST2and NT-proBNP at the day of echocardiographic examination. Right hear failurewas graded according to tricuspid annular plane systolic excursion (TAPSE) asfollows: (I: TAPSE > 24 mm (n=23); II: TAPSE 18-24 mm (n=53); III: TAPSE <18 (n=13)). Results: 89 patients were included. Both ST2 and NT-proBNP increasedsignificantly according to decreasing grades of right heart failure (ST2: p=0.006,NT-proBNP: p=0.002). ST2 correlated univariably with TAPSE (p=0.003). Inmultivariable linear regression models adjusted for clinical characteristics andcardiac comorbidities (age, sex, creatinine, NT-proBNP, arterial hypertension,coronary artery disease and RVF), only RVF and NT-proBNP were significantlyassociated with ST2 (RVF: Beta -0.193, T -2.055, p=0.043; NT-proBNP: Beta0.488, T 5.192, p=0.0001). Both, ST2 and NT-proBNP were able to discriminatepatients with grade III right heart failure (ST2: AUC=0.774, p=0.002;NT-proBNP: AUC=0.805, p=0.0001). In multivariable logistic regression modelsST2 was still associated significantly with right heart failure grade III (ST2:OR=0.974; p=0.006) after adjusting with age, sex, creatinine and NT-proBNP. Conclusions: This study demonstrates that ST2 may serve as a novel biomarker forthe early detection of right heart failure even in patients with a preserved leftventricular function.Appropriate assessment of right heart failure is more regarded as a mere bystanderand victim of pathological cardiovascular processes. However, the communicativerole of right ventricular function between pulmonary and systemic circulationdemands further investigation. Novel biomarkers, such as ST2, might facilitateearlier diagnosis of right ventricular dysfunction and thus lead to better clinicaloutcomes. This study aims to evaluate the association between ST2 and rightventricular function (RVF) assessed by echocardiography.

https://dgk.org/kongress_programme/ht2021/P329.htm