title: Plasma soluble ST2 levels correlate with disease severity and predict clinical worsening in patients with pulmonary arterial hypertension.
abstract: BACKGROUND
  Soluble suppression of tumorigenicity (sST2) has been proposed to be a marker for biomechanical strain and a possible predictor of mortality in patients with chronic heart failure. The use of sST2 in pulmonary arterial hypertension (PAH) has not been well defined.
  
  
  OBJECTIVE
  Plasma sST2 levels may correlate with the disease severity and predict clinical worsening in PAH.
  
  
  METHODS
  We performed a cohort study of 40 idiopathic PAH patients with data on demographics, exercise capacity, echocardiographic parameters, laboratory tests, hemodynamics, and medications. Plasma sST2 was assessed with the high-sensitivity ST2 ELISA kit at diagnostic catheterization. All patients were followed up from the date of blood sampling. The endpoint was clinical worsening.
  
  
  RESULTS
  sST2 was significantly elevated in patients with idiopathic PAH compared with control subjects (28.9 ± 13.9 vs 20.7 ± 7.5 ng/mL, P = 0.003). Pearson correlation analysis revealed that sST2 levels correlated with cardiac index (r = -0.534, P = 0.000) and pulmonary vascular resistance (r = 0.350, P = 0.027), and could reflect disease severity of PAH. After a mean follow-up of 14 ± 5 months, 12 patients showed clinical worsening. Receiver operating characteristic analysis suggested that sST2 levels >31.4 ng/mL discriminated clinical worsening with a sensitivity and specificity of 83.3% and 78.6%, respectively. Kaplan-Meier analysis showed that higher sST2 levels (>31.4 ng/mL) were associated with poor clinical outcomes (P = 0.008). Multivariate Cox regression analysis showed that sST2 was an independent predictor of clinical worsening (hazard ratio: 6.067, 95% confidence interval: 1.317-27.948, P = 0.021).
  
  
  CONCLUSIONS
  sST2 correlates with disease severity and is a significant predictor of clinical worsening in patients with PAH.
authors: Ya-Guo
authors: YG
authors: Zheng
authors: Tao
authors: T
authors: Yang
authors: Jian-Guo
authors: JG
authors: He
authors: Guo
authors: G
authors: Chen
authors: Zhi-Hong
authors: ZH
authors: Liu
authors: Chang-Ming
authors: CM
authors: Xiong
authors: Qing
authors: Q
authors: Gu
authors: Xin-Hai
authors: XH
authors: Ni
authors: Zhi-Hui
authors: ZH
authors: Zhao
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D000072179:Interleukin-1 Receptor-Like 1 Protein; D008297:Male; D011956:Receptors, Cell Surface / Q000097:blood*; D017472:Receptors, Interleukin-1 / Q000097:blood
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D011956:Receptors, Cell Surface; D017472:Receptors, Interleukin-1