Abstract
Prognostic stratification in pulmonary arterial hypertension (PAH) relies on clinical assessment and invasive hemodynamic measurements. However, right ventricular (RV) dilatation and function, assessed by cardiac magnetic resonance (CMR), have been demonstrated to predict survival independent of invasive indices. Soluble ST2 (sST2),a marker of cardiomyocyte stress related to the IL33/IL1-receptor system, increases in heart failure, especially when RV overload is present. Aim of this study was to explore sST2 and IL-33 levels in PAH, and to evaluate their possible correlation with cardiac remodeling as assessed by CMR
25 patients with PAH underwent contrast-enhanced CMR and measurement of serum sST2, IL-33 and NT-proBNP levels.10 age-matched healthy individuals with a negative echocardiogram served as controls.
PAH patients showed increased sST2 levels compared with controls. Patients with sST2 levels above and below the median differed significantly in terms of WHO class, walking distance, RV diastolic and systolic volume indices, and ejection fraction. Analysis of CMR data showed strong correlation of sST2 levels with right ventricular end-systolic volume and NT-proBNP, as well as a significant negative correlation with RV ejection fraction. Regression analysis suggested independent predictive value of the two biomarkers with respect to RV function.
Serum sST2 levels are elevated in patients with PAH, and they are strictly correlated with the severity of right heart remodeling and dysfunction. sST2 appears as a promising novel biomarker and a potentially useful tool for the non- invasive assessment of RV dysfunction.
- © 2013 ERS
