PLoS ONE (Jan 2015)

Elevated Plasma Soluble ST2 Is Associated with Heart Failure Symptoms and Outcome in Aortic Stenosis.

  • Patrizio Lancellotti,
  • Raluca Dulgheru,
  • Julien Magne,
  • Christine Henri,
  • Laurence Servais,
  • Nassim Bouznad,
  • Arnaud Ancion,
  • Christophe Martinez,
  • Laurent Davin,
  • Caroline Le Goff,
  • Alain Nchimi,
  • Luc Piérard,
  • Cécile Oury

DOI
https://doi.org/10.1371/journal.pone.0138940
Journal volume & issue
Vol. 10, no. 9
p. e0138940

Abstract

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B-type natriuretic peptide (BNP) is often used as a complementary finding in the diagnostic work-up of patients with aortic stenosis (AS). Whether soluble ST2, a new biomarker of cardiac stretch, is associated with symptomatic status and outcome in asymptomatic AS is unknown. sST2 and BNP levels were measured in 86 patients (74±13 years; 59 asymptomatic, 69%) with AS (23 ng/mL, AUC = 0.68, p<0.01) was more accurate to identify asymptomatic patients or those who developed symptoms during follow-up. sST2 was independently related to left atrial index (p<0.0001) and aortic valve area (p = 0.004; model R2 = 0.32). A modest correlation was found with BNP (r = 0.4, p<0.01). During follow-up, 29 asymptomatic patients (34%) developed heart failure symptoms. With multivariable analysis, peak aortic jet velocity (HR = 2.7, p = 0.007) and sST2 level (HR = 1.04, p = 0.03) were independent predictors of cardiovascular events. In AS, sST2 levels could provide complementary information regarding symptomatic status, new onset heart failure symptoms and outcome. It might become a promising biomarker in these patients.