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

Levels of soluble suppression-of-tumorigenesis-2 are associated with impaired right ventricular function in patients with preserved ejection fraction
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;
Background: Appropriate assessment of right ventricular function (RVF) – oftenneglected – is more regarded as a mere bystander and victim of pathological cardiovascular processes. However, its communicative role between pulmonaryand systemic circulation demands further investigation even in patients with preserved left ventricular systolic function. The biomarker soluble suppression-of-tumorigenesis-2 (sST2) may increase cardiac fibrosis andventricular dysfunction. Therefore, this study aims to evaluate the association between sST2 and RVF in patients undergoing cardiac magnetic resonance imaging (cMRI).
Methods: Consecutive patients undergoing cMRI were
prospectively enrolled. Longitudinal RVF was assessed by tricuspid annular systolic excursion (TAPSE). Patients with left ventricular dysfunction (<50%) were excluded. At the time of cMRI blood samples for measurements of sST2were collected.
Results: 72 patients were included. Median levels of sST2 increased significantly
according to decreasing TAPSE (r=-0.229; p=0.053; TAPSE < 15 mm, median 32.75μg/l; TAPSE >= 15 mm, median 24.50μg/l; p=0.043). sST2 levels discriminated significantly patients with impaired RVF (TAPSE <15mm) (AUC:0.660; p=0.043). Even after multivariable adjustment, sST2 was still associated significantly with TAPSE in linear regression (Beta -0.299; T -2.413; p=0.018)and impaired RVF in logistic regression models (TAPSE <15mm; OR=4.956;95% CI 0.057-0.719; p=0.014).
Conclusion: This study demonstrates that decreasing levels of sST2 are associated with impaired RVF in patients with preserved LVF being assessed by cMRI.