The Relationship Between The Level Of Serum SST2 And Cardiac Function And Left Ventricular Remodeling In Heart Failure Patients

Objective: To examine the value of s ST2 for risk stratification and cardiac function evaluation in heart failure patents; and assess the correlation of the level of s ST2 in CHF patients and ventricular remodeling; the other aim is to assess whether s ST2 predict endpoint events among a population of patients with CHF.Method: 195 CHF patients admitted in Tianjin Union Medical Center from January 2014 to June 2015 were enrolled in this study according to the entry criteria and exclusion criteria guilding by 2014 Chinese heart failure diagnosis and treatment guidelines; 30 elderly healthy adults were enrolled as control group. Serum s ST2,NT-pro BNP,hs-CRP and other indicators were detected;echocardiography index(LAD 、 LVEDD 、 IVST 、 LVPWT 、 LVEF) were measured;the HF rehospitalization and cardiovascular death events of heart failure patients were followed, and then divided into different subgroups use statistical analysis.Results: 1.The level of s ST2 in HF Patients was higher than the control group, and increased with the NYHA classification.The level of s ST2 in NYHA III and IV grade group was higher than the control group and NYHA I, II grade, NYHA IV grade group was higher than NYHA III grade group, the difference was statistically significant(P < 0.05).2. The levels of s ST2 increased with the development phase of HF.B, C,and D Phase of HF were higher than A.D Phase of HF was higher than B and C phase, the difference was statistically significant(P < 0.05).3. The level of s ST2 rised with the level of LVEF, among all the groups were statistically significant(P < 0.05).4. Among different renal fuction groups and different pathogenesis of HF groups have no statistical significance in serum s ST2 level.5. The area under the ROC curve of s ST2 was 0.686(95% ci: 0.585 0.787, P < 0.01), and the NT- pro BNP was 0.697(95% ci: 0.604 0.791, P < 0.01).Best cut off value of s ST2 to predicted the primary endpoint events of HF was 118.80 ng/ml, NT- pro BNP was 2381.50 ng/ml.6. The high level of s ST2 group had poor end point events,poor SHFM life expectancy and large LVEDD than the low level of s ST2 group, the difference was statistically significant(P < 0.05).7. The level of s ST2, NT- pro BNP, LVEDD were higher in the happened primary endpoint events group,and the level of LVEF, SHFM life expectancywere was lower, the difference was statistically significant(P < 0.05).8. The correlation analysis found that the s ST2 and NT- proBNP, Tn T, hs-CRP, LVEDD were positively correlated, and negative correlation with LVEF; SHFM life expectancy and s ST2, NT- pro BNP, LVEDD showed a negative correlation, and LVEF were positively correlated.9. Survival analysis found that the survival rate of the high level of sST2 was lower than the low level of s ST2 group, the difference was statistically significant(P < 0.05); COX proportional hazards regression model, find that the risk of primary endpoint event in the high level of s ST2 group was 3.37 times higher than the low level group;and NT- pro BNP was 1.92 times.Conclusion: 1. The level of Serum s ST2 increases with NYHA classification and increases with the decreasing of LVEF, s ST2 associated with the NT-pro BNP, LVEF, it can evaluate the cardiac function in patients with heart failure coordination with the NT-pro BNP.2. The level of Serum sST2 increased in the phase B of HF, but the NT-proBNP increased in the phase C of HF, so the serum s ST2 can found the potential heart failure, and it is correlated with LVEDD, can reflect the degree of ventricular remodeling to a certain extent.3. The primary endpoint event probability was higher in the high level group, and negatively correlated with SHFM life expectancy, and the risk of endpoint event occurrence is highert than NT- pro BNP, so the level of serum s ST2 for the prediction of prognosis of heart failure is probley higher than the NT- pro BNP.