Diagnostic Significance of the Level of Soluble Stimulating Growth Factor in Patients with Spondyloarthritis as an Early Marker of Cardiovascular Pathology

Abstract

Aim to determine the clinical and laboratory relationships of the level of soluble stimulating growth factor expressed by genome 2 (sST2) with indicators characterizing the development of cardiovascular pathology in patients with spondyloarthritis (SPA). Materials and methods. A total of 46 patients aged 39.2 ± 10.2 years with SpA (including 40 (87 %) with ankylosing spondylitis, 6 (13 %) with psoriatic arthritis) were examined. There were 36 (78.3 %) males, 10 (21.7 %) females among the enrolled patients. 27 (84.4 %) of 32 examined patients had HLA-B27. To assess the disease activity the BASDAI and ASDAS scores were used, the erythrocyte sedimentation rate and C-reactive protein values were measured; the levels of tumor necrosis factor-alpha (TNF-alpha), N-terminal fragment of brain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), sST2 in blood serum were evaluated. Traditional cardiovascular risk factors, aortic pulse wave velocity (PWVAo), the results of standard electrocardiography, transthoracic echocardiography, carotid duplex ultrasonography were assessed. Results. The mean sST2 level was 33.34±11.2 ng/ml, an sST2 concentration above the threshold value was found in 19 (41.3 %) patients. No significant relationships between serum sST2 level and disease activity indicators, echocardiographic parameters, rhythm and/or conduction disturbances on electrocardiograms were found. A higher PWVAo was noted in patients with sST2 level above the average (p=0.036); the level of NT-proBNP was more often increased in patients with high levels of sST2 (p=0.085). Higher sST2 concentrations were found in patients treated with biological disease-modifying antirheumatic drugs due to the high disease activity (р=0.039). Conclusion. An increase in sST2 levels was found in 41.3 % of patients with SpA. An increase in serum sST2 concentration is associated with an elevated PWVAo and an increase in the level of NT-proBNP, which may indicate incipient cardiac remodeling, cardiac fibrosis, and the initial stages of the development of heart failure. The new data obtained indicate the advisability of planning and performing larger prospective studies of patients with SpA for the early detection of preclinical signs of damage to the cardiovascular system, cardiac remodeling, and assessment of the effectiveness of therapy.

Keywords

• spondyloarthritis
• ankylosing spondylitis
• sst2
• nt-probnp