Document Detail


Serum levels of the interleukin-1 receptor family member ST2, cardiac structure and function, and long-term mortality in patients with acute dyspnea.
MedLine Citation:
PMID:  19808354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: ST2, a biomarker of cardiomyocyte stretch, powerfully predicts poor outcomes in patients with acute dyspnea, but nothing is known about associations between soluble ST2 (sST2) and cardiac structure and function, or whether sST2 retains prognostic meaning in the context of such measures. METHODS AND RESULTS: One hundred thirty-four dyspneic patients with and without decompensated heart failure had echocardiography during index admission and vital status was ascertained at 4 years. Echocardiographic and clinical correlates of sST2 as well as independent predictors of death at 4 years were identified. sST2 correlated with left ventricular end-systolic dimensions/volumes and left ventricular ejection fraction. sST2 was inversely associated with right ventricular fractional area change (rho=-0.18; P=0.046), higher right ventricular systolic pressure (rho=0.26; P=0.005), and right ventricular hypokinesis (P<0.001) and was correlated with tissue Doppler Ea wave peak velocity, but not to other indices of diastolic function. In multivariate regression, independent predictors of sST2 included right ventricular systolic pressure (t=2.29; P=0.002), left ventricular ejection fraction (t=-2.15; P=0.05) and dimensions (end systolic, t=2.57; end diastolic, t=2.98; both P<0.05), amino-terminal pro-B-type natriuretic peptide (t=3.31; P=0.009), heart rate (t=2.59; P=0.01), and presence of jugular venous distension (t=2.00; P=0.05). In a Cox proportional hazards model that included echocardiographic results and other biomarkers, sST2 independently predicted death at 4 years (hazard ratio=2.70; P=0.003). CONCLUSIONS: Among dyspneic patients with and without acute heart failure, sST2 concentrations are associated with prevalent cardiac abnormalities on echocardiography, a more decompensated hemodynamic profile and are associated with long-term mortality, independent of echocardiographic, clinical, or other biochemical markers of risk.
Authors:
Ravi V Shah; Annabel A Chen-Tournoux; Michael H Picard; Roland R J van Kimmenade; James L Januzzi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-05-14
Journal Detail:
Title:  Circulation. Heart failure     Volume:  2     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Biological Markers / blood
Dyspnea / blood*,  mortality*
Female
Heart Failure / blood*,  mortality*,  physiopathology
Humans
Male
Middle Aged
Predictive Value of Tests
Receptors, Cell Surface / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/IL1RL1 protein, human; 0/Receptors, Cell Surface

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