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Relationship of soluble ST2 to pulmonary hypertension severity in patients undergoing cardiac resynchronization therapy

  
@article{JTD33767,
	author = {Jonathan Beaudoin and Jackie Szymonifka and Zachary Lavender and Roderick C. Deaño and Qing Zhou and James L. Januzzi and Jagmeet P. Singh and Quynh A. Truong},
	title = {Relationship of soluble ST2 to pulmonary hypertension severity in patients undergoing cardiac resynchronization therapy},
	journal = {Journal of Thoracic Disease},
	volume = {11},
	number = {12},
	year = {2019},
	keywords = {},
	abstract = {Background: Pulmonary hypertension (PH) is an adverse prognostic marker in patients undergoing cardiac resynchronization therapy (CRT). We sought to determine the relation of biomarkers of fibrosis [soluble ST2 (sST2), galectin-3], wall stretch [amino terminal pro-brain natriuretic peptide (NT-proBNP)], and necrosis [high-sensitivity troponin-I (hsTnI)] to PH severity in CRT patients.
Methods: Biomarkers and right ventricular systolic pressure (RVSP) were measured at CRT implant and 6-month later (n=111). PH was categorized into 3 groups based on RVSP: no (60 mmHg). Patients were categorized as progressors (worsened PH), persistent PH (no change) and regressors (improved PH). Endpoints were 6-month CRT response and 2-year major adverse cardiac event (MACE).
Results: RVSP was associated with CRT nonresponse (P=0.02) and MACE (P=0.03). Severe PH patients had 5-fold increase risk for CRT nonresponse (OR 5.0, P=0.04) and MACE (HR 5.7, P=0.04) over non-PH patients. Progressors and persistent PH patients had >2-fold odds for CRT non-response (OR 2.8, P=0.45) and >11-fold increase in MACE compared to no PH patients or regressors (HR 11.6, P=0.02). Only NT-proBNP and sST2 were discernable between PH groups, with graded increase based on PH severity (both P≤0.02), and lower values in regressors versus non-regressors (both P≤0.01). Levels of sST2 decreased at 6 months in regressors (15 ng/mL, P=0.03) and increased slightly (3–8 ng/mL) in non-regressors, without difference for NT-proBNP (P=0.08).
Conclusions: sST2 levels are related with PH severity in CRT patients. Serial sST2 changes after CRT implant suggests potential role to monitor PH after CRT.},
	issn = {2077-6624},	url = {https://jtd.amegroups.com/article/view/33767}
}