The Comparison Of Diagnostic Value Between Soluble ST2and Pro-BNP In Patients With Heart Failure

Background: COPD patients with prolonged course, increased pulmonaryvascular resistance, eventually leading to right ventricular failure; Heart failureis one of the major complications of Advanced COPD, is the main cause ofdeath in patients with COPD. If early diagnosis is possible for COPD withheart failure, and explore an effective way to evaluate the severity of disease,and thus early prevention is of positive significance to improve symptoms anddelay the progression of complications.ST2is the IL-33receptor, the ST2gene encoding two different cleavageproducts, namely serum soluble ST2protein (sST2) and transmembrane ST2protein (ST2L). In the clinical context, the level of serum sST2wassignificantly higher in patients with dengue virus infection, sepsis and trauma,pulmonary fibrosis, food allergies, subarachnoid hemorrhage and hearttransplantation, and a number of studies have shown that sST2has importantclinical significance for Coronary Heart Disease in diagnosis, prognosis andrisk stratification, but the diagnostic value in COPD patients with heart failure，There is no clear reports.Objective: This article will test the sST2level of COPD patients with heartfailure, compared to explore that whether there is diagnostic value of the sST2level in COPD patients with heart failure. Methods:40COPD patients with heart failure and also40heart failurepatients without COPD were selected in the observation group, they were givenconventional symptomatic treatment to correct heart failure two weeks. beforeand after the treatment, we detect the Pro-BNP and sST2level changes inserum, at the same time, we select20normal subjects as the healthy controlgroup, the determination of the serum Pro-BNP and sST2level of, detect thePro-BNP and sST2level changes in serum, we contrasted the various indicatorsamong the groups using the statistical method.Results:1. Before the treatment, compared with healthy controls andinfection group, two groups of patients with heart failure Pro-BNP levelssignificantly increased, and the difference was statistically significant (P<0.05),the serum sST2level difference was not statistically significant (P>0.05) inCOPD patients with heart failure, the serum sST2levels in heart failure patientswithout COPD group were significantly increased, and the difference wasstatistically significant (P<0.05);2.After the treatment, the serum Pro-BNPlevels was significantly decreased than before in COPD patients with heartfailure group, the difference was statistically significant (P<0.05), sST2levelcompared with pre-treatment difference was not statistically significant(P>0.05); in heart failure patients without COPD group，serum Pro-BNP andsST2levels decreased significantly than before treatment, the difference wasstatistically significant (P<0.05).3,The AUCROCof sST2for COPD patientswith heart failure is0.599（95%CI:0.472~0.725）;The AUCROCof sST2for heart failure patients without COPD is0.835（95%CI:0.744~0.926）;theAUCROCof Pro-BNP for COPD patients with heart failure is0.914，（95%CI:0.837~0.991）；The AUCROCof Pro-BNP for heart failure patientswithout COPD is0.951（95%CI:0.900~1.002）.Conclusion: sST2is not recommended as a diagnostic marker for COPDwith heart failure patients, sST2have moderate diagnostic value for heartfailure patients without COPD, Pro-BNP have a higher diagnostic value forCOPD with heart failure patients and heart failure patients without COPD.