Soluble Suppression of Tumorigenicity 2 and Echocardiography in Sepsis
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Soluble suppression of tumorigenicity 2 (sST2) has emerged as a biomarker of cardiac stretch or remodeling, and has demonstrated a role in acutely decompensated heart failure. However, its role in sepsis-induced cardiac dysfunction is still unknown. We explored whether sST2 serum concentration reflects either systolic or diastolic dysfunction as measured by Doppler echocardiography. In a total of 127 patients with sepsis, correlations between sST2 and blood pressure, left ventricular (LV) ejection fraction, LV diastolic filling (ratio of early transmitral flow velocity to early diastolic mitral annulus velocity), and resting pulmonary arterial pressure were evaluated. Correlations between sST2 and other sepsis biomarkers (high-sensitivity C-reactive protein [hs-CRP] and procalcitonin) were also examined. sST2 showed a moderate correlation with mean arterial pressure (r=-0.3499) but no correlation with LV ejection fraction, diastolic filling, or resting pulmonary hypertension. It showed moderate correlations with hs-CRP and procalcitonin (r=0.2608 and r=0.3829, respectively). sST2 might have a role as a biomarker of shock or inflammation, but it cannot reflect echocardiographic findings of LV ejection fraction or diastolic filling in sepsis.
Abstract
Soluble suppression of tumorigenicity 2 (sST2) has emerged as a biomarker of cardiac stretch or remodeling, and has demonstrated a role in acutely decompensated heart failure. However, its role in sepsis-induced cardiac dysfunction is still unknown. We explored whether sST2 serum concentration reflects either systolic or diastolic dysfunction as measured by Doppler echocardiography. In a total of 127 patients with sepsis, correlations between sST2 and blood pressure, left ventricular (LV) ejection fraction, LV diastolic filling (ratio of early transmitral flow velocity to early diastolic mitral annulus velocity), and resting pulmonary arterial pressure were evaluated. Correlations between sST2 and other sepsis biomarkers (high-sensitivity C-reactive protein [hs-CRP] and procalcitonin) were also examined. sST2 showed a moderate correlation with mean arterial pressure (r=-0.3499) but no correlation with LV ejection fraction, diastolic filling, or resting pulmonary hypertension. It showed moderate correlations with hs-CRP and procalcitonin (r=0.2608 and r=0.3829, respectively). sST2 might have a role as a biomarker of shock or inflammation, but it cannot reflect echocardiographic findings of LV ejection fraction or diastolic filling in sepsis.
참고문헌 (20)
- Singer M, "The third international consensus definitions for sepsis and septic shock (Sepsis-3)", JAMA, 315, pp.801~810 (2016)
- Dellinger RP, "Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012", Crit Care Med, 41, pp.580~637 (2013)
- Weir RA, "Serum soluble ST2: a potential novel mediator in left ventricular and infarct remodeling after acute myocardial infarction", J Am Coll Cardiol, 55, pp.243~250 (2010)
- Januzzi JL, "ST2 and prognosis in acutely decompensated heart failure: the International ST2 Consensus Panel", Am J Cardiol, 115(7 Suppl), pp.26B~31B (2015)
- Brunner M, "Increased levels of soluble ST2 protein and IgG1 production in patients with sepsis and trauma", Intensive Care Med, 30, pp.1468~1473 (2004)
- 허미나, "Soluble ST2 Has a Prognostic Role in Patients With Suspected Sepsis", Annals of Laboratory Medicine, 35(6), pp.570~577 (2015), 대한진단검사의학회
- Vincent JL, "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction", failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine, 1996, pp.22, 707~710
- Mueller T, "The Presage(®) ST2 Assay: analytical considerations and clinical applications for a high-sensitivity assay for measurement of soluble ST2", Expert Rev Mol Diagn, 13, pp.13~30 (2013)
- Lang RM, "Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology", J Am Soc Echocardiogr, 18, pp.1440~1463 (2005)
- Nagueh SF, "Doppler estimation of left ventricular filling pressure in sinus tachycardia. A new application of tissue doppler imaging", Circulation, 98, pp.1644~1650 (1998)
- Lima CO, "Noninvasive prediction of transvalvular pressure gradient in patients with pulmonary stenosis by quantitative two-dimensional echocardiographic Doppler studies", Circulation, 67, pp.866~871 (1983)
- Y-Hassan S, "Sepsis-induced myocardial depression and takotsubo syndrome", Acute Card Care, 16, pp.102~109 (2014)
- Vieillard-Baron A, "Actual incidence of global left ventricular hypokinesia in adult septic shock", Crit Care Med, 36, pp.1701~1706 (2008)
- Rudiger A, "Mechanisms of sepsis-induced cardiac dysfunction", Crit Care Med, 35, pp.1599~1608 (2007)
- Landesberg G, "Myocardial dysfunction in severe sepsis and septic shock: no correlation with inflammatory cytokines in real-life clinical setting", Chest, 148, pp.93~102 (2015)
- Yang HS, "Soluble ST2 and troponin I combination: Useful biomarker for predicting development of stress cardiomyopathy in patients admitted to the medical intensive care unit", Heart Lung, 44, pp.282~288 (2015)
- Miller WL, "Profiles of serial changes in cardiac troponin T concentrations and outcome in ambulatory patients with chronic heart failure", J Am Coll Cardiol, 54, pp.1715~1721 (2009)
- Logeart D, "Comparative value of Doppler echocardiography and B-type natriuretic peptide assay in the etiologic diagnosis of acute dyspnea", J Am Coll Cardiol, 40, pp.1794~1800 (2002)
- Weinberg EO, "Expression and regulation of ST2, an interleukin-1 receptor family member, in cardiomyocytes and myocardial infarction", Circulation, 106, pp.2961~2966 (2002)
- Bartunek J, "Nonmyocardial production of ST2 protein in human hypertrophy and failure is related to diastolic load", J Am Coll Cardiol, 52, pp.2166~2174 (2008)
