Serum soluble ST2 a potential novel mediator in left ventricular and infarct remodeling after acute myocardial infarction

Weir, R.A.P., Miller, A.M., Murphy, G., Clements, S., Steedman, T., Connell, J., McInnes, I. , Dargie, H. and McMurray, J.J. (2010) Serum soluble ST2 a potential novel mediator in left ventricular and infarct remodeling after acute myocardial infarction. Journal of the American College of Cardiology, 55(3), pp. 243-250. (doi:10.1016/j.jacc.2009.08.047) (PMID:20117403)

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Abstract

Objectives: This study sought to assess, for the first time, the relationship between serum concentrations of the soluble interleukin-1 receptor family member ST2 (sST2) and serial change in left ventricular (LV) function after acute myocardial infarction (AMI). Background: Serum sST2 levels are elevated early after AMI and are associated with lower pre-discharge LV ejection fraction and adverse cardiovascular outcomes. Methods: The sST2 levels were measured in 100 patients (mean age 58.9 ± 12.0 years; 77% male), admitted with AMI with resultant LV systolic dysfunction, at baseline and at 12 and 24 weeks. Patients underwent cardiac magnetic resonance imaging and measurement of N-terminal pro-brain natriuretic peptide, norepinephrine, and aldosterone at each time point. Results: Median sST2 decreased from 263.3 pg/ml at baseline to 140.0 pg/ml at 24 weeks (p < 0.001). Serum sST2 correlated significantly with LV ejection fraction at baseline (r = −0.30, p = 0.002) and 24 weeks (r = −0.23, p = 0.026); change in sST2 correlated with change in LV end-diastolic volume index (r = −0.24, p = 0.023). Level of sST2 was positively associated with infarct volume index at baseline (r = 0.26, p = 0.005) and 24 weeks (r = 0.22, p = 0.037), and with change in infarct volume index (r = −0.28, p = 0.001). Level of sST2 was significantly higher in patients with greater infarct transmurality and endocardial extent, and in the presence of microvascular obstruction. Level of sST2 correlated significantly with norepinephrine and aldosterone, but not with N-terminal pro-brain natriuretic peptide. Conclusions: Measurement of sST2 early after AMI assists in the prediction of medium-term LV functional recovery. Novel relationships were observed between sST2, infarct magnitude/evolution, and aldosterone. Serum sST2 may be of pathophysiological importance in ventricular and infarct remodeling after AMI. (Effects of Eplerenone on Left Ventricular Remodelling Following Heart Attack; NCT00132093)

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McInnes, Professor Iain and Murphy, Dr Grace and Miller, Dr Ashley and Dargie, Professor Henry and Connell, Professor John and McMurray, Professor John
Authors: Weir, R.A.P., Miller, A.M., Murphy, G., Clements, S., Steedman, T., Connell, J., McInnes, I., Dargie, H., and McMurray, J.J.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Journal of the American College of Cardiology
ISSN:0735-1097
ISSN (Online):1558-3597
Published Online:13 January 2010

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