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Research article
Jingmin Zhou
Zhongshan Hospital Fudan University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5010-0486
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Inflammation is considered to be one of the principal triggering mechanisms for Left ventricular (LV) fibroblast and remodeling in heart failure(HF), which are related to adverse events in HF failure patients. Soluble ST2 (sST2), a member of the interleukin-1 receptor family, is assumed to play a significant role in the inflammatory response of fibroblasts. The present study aimed to investigate the prognostic value of sST2/ left ventricular mass index (LVMI), a parameter of the pre-fibrotic inflammatory phase of heart failure in comparative to remodeling, in the heart failure with reduced ejection fraction (HFrEF).
Methods: The present study was a cohort study. A total of 45 consecutive patients with suspected HFrEF from 1/9/2015 to 31/12/2016 were prospectively enrolled. The target-independent variable was the ratio of sST2/LVMI measured at baseline. The primary endpoint was the composite endpoint of cardiovascular-cause mortality or heart failure readmission. The prognostic impact of the ratio of sST2/LVMI was evaluated by multivariable Cox proportional-hazards regression model.
Results: 45 patients were enrolled, the average age was 48±14 years old, and about 20% of them were male. Patients were followed for 9 months, during which the primary outcome occurred in 15 patients. By Kaplan–Meier analysis, patients with high ratio of the ratio of sST2/LVMI ≥ 0.39 had shorter event-free survival than the middle ( ratio of sST2/LVMI between 0.39 and 0.24) and low ratio of sST2/LVMI (ratio of sST2/LVMI < 0.24) patients (log-rank, P = 0.022). Results of fully-adjusted multivariable Cox regression analysis showed the ratio of sST2/LVMI was positively associated with the composite outcome of HFrEF patients after adjusting confounders hazard ratio (HR) 1.64, 95% CI (1.06, 2.54). By subgroup analysis, a stronger association was found in patients whose ages between 40 and 55 years old, systolic blood pressure ＜115 or≥129mmHg, diastolic blood pressure< 74 mmHg, hematocrit < 44.5%, and interventricular septum ≥8.5mm.
Conclusion: In HFrEF patients, the relationship between the ratio of sST2/LVMI and the composite outcome is linear. A higher baseline ratio of sST2/LVMI levels is associated with increased risk of cardiovascular-cause mortality and HF rehospitalization in patients with HFrEF in the short term follow up.
Keywords
Soluble suppression of tumorigenicity 2 (sST2), left ventricular mass index(LVMI), Heart failure, Prognosis, HFrEF
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View the published article at BMC Cardiovascular Disorders.
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Cardiovascular Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Jingmin Zhou
Zhongshan Hospital Fudan University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5010-0486
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cardiovascular Disorders.
Version 1
Posted 15 Oct, 2020
No community comments so far
Editorial decision: Revise before sending to peer reviewers
On 15 Oct, 2020
Editor assigned
On 29 Sep, 2020
Submission checks complete
On 28 Sep, 2020
Editor invited
On 28 Sep, 2020
First submitted
On 27 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cardiovascular Disorders.
Background: Inflammation is considered to be one of the principal triggering mechanisms for Left ventricular (LV) fibroblast and remodeling in heart failure(HF), which are related to adverse events in HF failure patients. Soluble ST2 (sST2), a member of the interleukin-1 receptor family, is assumed to play a significant role in the inflammatory response of fibroblasts. The present study aimed to investigate the prognostic value of sST2/ left ventricular mass index (LVMI), a parameter of the pre-fibrotic inflammatory phase of heart failure in comparative to remodeling, in the heart failure with reduced ejection fraction (HFrEF).
Methods: The present study was a cohort study. A total of 45 consecutive patients with suspected HFrEF from 1/9/2015 to 31/12/2016 were prospectively enrolled. The target-independent variable was the ratio of sST2/LVMI measured at baseline. The primary endpoint was the composite endpoint of cardiovascular-cause mortality or heart failure readmission. The prognostic impact of the ratio of sST2/LVMI was evaluated by multivariable Cox proportional-hazards regression model.
Results: 45 patients were enrolled, the average age was 48±14 years old, and about 20% of them were male. Patients were followed for 9 months, during which the primary outcome occurred in 15 patients. By Kaplan–Meier analysis, patients with high ratio of the ratio of sST2/LVMI ≥ 0.39 had shorter event-free survival than the middle ( ratio of sST2/LVMI between 0.39 and 0.24) and low ratio of sST2/LVMI (ratio of sST2/LVMI < 0.24) patients (log-rank, P = 0.022). Results of fully-adjusted multivariable Cox regression analysis showed the ratio of sST2/LVMI was positively associated with the composite outcome of HFrEF patients after adjusting confounders hazard ratio (HR) 1.64, 95% CI (1.06, 2.54). By subgroup analysis, a stronger association was found in patients whose ages between 40 and 55 years old, systolic blood pressure ＜115 or≥129mmHg, diastolic blood pressure< 74 mmHg, hematocrit < 44.5%, and interventricular septum ≥8.5mm.
Conclusion: In HFrEF patients, the relationship between the ratio of sST2/LVMI and the composite outcome is linear. A higher baseline ratio of sST2/LVMI levels is associated with increased risk of cardiovascular-cause mortality and HF rehospitalization in patients with HFrEF in the short term follow up.
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