Abstract
Heart failure (HF), being the final chord of most diseases of the cardiovascular system, is a serious socio-economic problem. Timely diagnosis and application of optimal treatment strategies appropriate to specific clinical circumstances helps to reduce the risk of developing negative outcomes in HF. Circulating biological markers are an integral element of algorithms for diagnosis, risk stratification and prognosis assessment in patients with heart failure. The recommended natriuretic peptides have a number of limitations, which served as the basis for the search for new substances as markers of HF. Among the many new variants that are considered as candidates for biomarkers of heart failure, one of the most promising is the biomarker of ‘mechanical’ myocardial stress – soluble ST2. This review article discusses the possibility of using ST2 in clinical practice in patients with decompensated heart failure.
References
- Roger V.L. Epidemiology of heart failure. Circ. Res. 2013; 113 (6): 646–59. DOI: 10.1161/CIRCRESAHA.113.300268
- Scientific organization committee of (ESSE-RF project). Epidemiology of cardiovascular diseases in different regions of Russian Federation. Design of the study. Preventive medicine. 2013; 6: 25–34 (in Russ.).
- Ponikowski P., Voors A., Anker S. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur. Heart J. 2016; 37 (27): 2129– 200. DOI: 10.1093/eurheartj/ehw128
- Kamardinov D.K., Songurov R.N., Ioshina V.I., Buziashvili Yu.I. Soluble ST2 – as a biomarker, a tool for risk stratification and therapeutic target in patients with chronic heart failure. Kardiologiia. 2020; 60 (2): 111–21 (in Russ.). DOI: 10.18087/cardio.2020.2.n816
- Bayés-Genís A., Núñez J., Lupón J. Soluble ST2 for prognosis and monitoring in heart failure: the new gold standard? J. Am. Coll. Cardiol. 2017; 70 (19): 2389–92. DOI: 10.1016/j.jacc.2017.09.031
- Matilla L., Arrieta V., Jover E. Soluble St2 induces cardiac fibroblast activation and collagen synthesis via neuropilin-1. Cells. 2020; 9 (7): 1667. DOI: 10.3390/cells9071667
- Matilla L., Ibarrola J., Arrieta V. Soluble ST2 promotes oxidative stress and inflammation in cardiac fibroblasts: an in vitroand in vivo study in aortic stenosis. Clin. Sci. (Lond). 2019; 133 (14): 1537–48. DOI: 10.1042/CS20190475
- Sanada S., Hakuno D., Higgins L., Schreiter E., McKenzie A., Lee R. IL-33 and ST2 comprise a critical biomechanically induced and cardioprotective signaling system. J. Clin. Invest. 2007; 117 (6): 1538– 49. DOI:10.1172/JCI30634
- Weinberg E. ST2 protein in heart disease: from discovery to mechanisms and prognostic value. Biomark. Med. 2009; 3 (5): 495–511. DOI: 10.2217/bmm.09.56
- McCarthy C., Januzzi J. Jr. Soluble ST2 in heart failure. Heart Fail. Clin. 2018; 14 (1): 41–8. DOI: 10.1016/j. hfc.2017.08.005
- Yancy C., Jessup M., Bozkurt B. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Failure Society of America. Circulation. 2017; 136 (6): e137–e161. DOI: 10.1161/CIR.0000000000000509
- Bozkurt B. What is new in heart failure management in 2017? Update on ACC/AHA Heart Failure Guidelines. Curr. Cardiol. Rep. 2018; 20 (6): 39. DOI: 10.1007/s11886-018-0978-7 13. Dattagupta A., Immaneni S. ST2: current status. Indian Heart J. 2018; 70 (Suppl. 1): S96–S101. DOI: 10.1016/j.ihj.2018.03.001
- Aimo A., Vergaro G., Passino C. Prognostic value of soluble suppression of tumorigenicity-2 in chronic heart failure: a meta-analysis. JACC Heart Fail. 2017; 5 (4): 280–6. DOI: 10.1016/j.jchf.2016.09.010
- Zhang Z., Shen B., Cao X. Increased soluble suppression of tumorigenicity 2 level predicts all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study. Blood Purif. 2017; 43 (1–3): 37–45. DOI: 10.1159/000452924
- Bahuleyan C., Alummoottil G., Abdullakutty J. Prognostic value of soluble ST2 biomarker in heart failure patients with reduced ejection fraction – A multicenter study. Indian Heart J. 2018; 70 (Suppl. 1): S79–S84. DOI: 10.1016/j.ihj.2017.09.010
- Ramkumar N., Jacobs J., Berman R. Cardiac biomarkers predict long-term survival after cardiac surgery. Ann. Thorac. Surg. 2019; 108 (6): 1776–82. DOI: 10.1016/j. athoracsur.2019.04.123
- Broch K., Ueland T., Nymo S. Soluble ST2 is associated with adverse outcome in patients with heart failure of ischaemic aetiology. Eur. J. Heart Fail. 2012; 14 (3): 268–77. DOI: 10.1093/eurjhf/hfs006
- Teerlink J., Cotter G., Davison B. Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebocontrolled trial. Lancet. 2013; 381 (9860): 29–39. DOI: 10.1016/S0140-6736(12)61855-8
- Januzzi J., Camargo C., Anwaruddin S. The N-terminal pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am. J. Cardiol. 2005; 95 (8): 948–54. DOI: 10.1016/j.amjcard.2004.12.032
- Dieplinger B., Mueller T. Soluble ST2 in heart failure. Clin. Chim. Acta. 2015; 443: 57–70. DOI: 10.1016/j. cca.2014.09.021
- Mueller T., Leitner I., Egger M., Haltmayer M., Dieplinger B. Association of the biomarkers soluble ST2, galectin-3 and growth-differentiation factor-15 with heart failure and other non-cardiac diseases. Clin. Chim. Acta. 2015; 445: 155–60. DOI: 10.1016/j. cca.2015.03.033
- Rehman S., Martinez-Rumayor A., Mueller T., Januzzi J. Independent and incremental prognostic value of multimarker testing in acute dyspnea: results from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) study. Clin. Chim. Acta. 2008; 392 (1–2):41–5. DOI: 10.1016/j.cca.2008.03.002
- Shah N., Ayyadurai P., Saad M. Galactin-3 and soluble ST2 as complementary tools to cardiac MRI for sudden cardiac death risk stratification in heart failure: a review. JRSM Cardiovasc. Dis. 2020; 9: 2048004020957840. DOI: 10.1177/2048004020957840
- Lassus J., Gayat E., Mueller C. Incremental value of biomarkers to clinical variables for mortality prediction in acutely decompensated heart failure: the Multinational Observational Cohort on Acute Heart Failure (MOCA) study. Int. J. Cardiol. 2013; 168 (3): 2186–94. DOI: 10.1016/j.ijcard.2013.01.228 106
- van Vark L., Lesman-Leegte I., Baart S. Prognostic value of serial ST2 measurements in patients with acute heart failure. J. Am. Coll. Cardiol. 2017; 70 (19): 2378– 88. DOI: 10.1016/j.jacc.2017.09.026
- Boisot S., Beede J., Isakson S. Serial sampling of ST2 predicts 90-day mortality following destabilized heart failure. J. Card. Fail. 2008; 14 (9): 732–8. DOI: 10.1016/j.cardfail.2008.06.415
- Tang W., Wu Y., Grodin J. Prognostic value of baseline and changes in circulating soluble ST2 levels and the effects of nesiritide in acute decompensated heart failure. JACC Heart Fail. 2016; 4 (1): 68–77. DOI: 10.1016/j.jchf.2015.07.015
- Dalal J., Digrajkar A., Das B., Bansal M., Toomu A., Maisel A. ST2 elevation in heart failure, predictive of a high early mortality. Indian Heart J. 2018; 70 (6): 822–7. DOI: 10.1016/j.ihj.2018.08.019
- Morin D., Chong-Yik R., Thihalolipavan S. Utility of serial measurement of biomarkers of cardiovascular stress and inflammation in systolic dysfunction. Europace. 2020; 22 (7): 1044–53. DOI: 10.1093/europace/euaa075
- Weinberg E., Shimpo M., Hurwitz S., Tominaga S., Rouleau J., Lee R. Identification of serum soluble ST2 receptor as a novel heart failure biomarker. Circulation. 2003; 107 (5): 721–6. DOI: 10.1161/01.cir.0000047274.66749.fe
- French B., Wang L., Ky B. Prognostic value of galectin-3 for adverse outcomes in chronic heart failure. J. Card. Fail. 2016; 22 (4): 256–62. DOI: 10.1016/j. cardfail.2015.10.022
- Villacorta H., Maisel A. Soluble ST2 testing: a promising biomarker in the management of heart failure. Arq. Bras. Cardiol. 2016; 106 (2): 145–52. DOI: 10.5935/abc.20150151
- Aleksova A., Paldino A., Beltrami A. Cardiac biomarkers in the emergency department: the role of soluble ST2 (sST2) in acute heart failure and acute coronary syndrome-there is meat on the bone. J. Clin. Med. 2019; 8 (2): 270. DOI: 10.3390/jcm8020270
- Henry-Okafor Q., Collins S., Jenkins C. Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes. Open Biomark. J. 2012; 2012 (5): 1–8. DOI: 10.2174/1875318301205010001
- Lin Y., Zhang R., Hou L. Distribution and clinical association of plasma soluble ST2 during the development of type 2 diabetes. Diabetes Res. Clin. Pract. 2016; 118: 140–5. DOI: 10.1016/j.diabres.2016.06.006
- Skvortsov A.A., Narusov O.Yu., Muksinova M.D. Soluble ST2 – biomarker for prognosis and monitoring in decompensated heart failure. Kardiologiia. 2019; 59 (11S): 18–27 (in Russ.). DOI: 10.18087/cardio.n765
- Bayes-Genis A., Richards A., Maisel A., Mueller C. Multimarker testing with ST2 in chronic heart failure. Am. J. Cardiol. 2015; 115 (7 Suppl): 76B–80B. DOI: 10.1016/j.amjcard.2015.01.045
- Sudharshan S., Novak E., Hock K., Scott M., Geltman E. Use of biomarkers to predict readmission for congestive heart failure. Am. J. Cardiol. 2017; 119 (3): 445–51. DOI: 10.1016/j.amjcard.2016.10.022
- Gastelurrutia P., Pascual-Figal D., Vazquez R. Obesity paradox and risk of sudden death in heart failure results from the MUerte Subita en Insuficiencia Cardiaca (MUSIC) study. Am. Heart J. 2011; 161 (1): 158–64. DOI: 10.1016/j.ahj.2010.10.018
- Songurov R.N., Koksheneva I.V., Ibragimov R.M., Alimov V.P., Tugeeva E.F., Buziashvill Yu.I. Dynamics of heart failure markers NT-proBNP and ST2 in assessing the prospects for myocardial revascularization in a patient with ischemic left ventricular dysfunction. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2022; 23 (6): 597–605 (in Russ.). DOI: 10.24022/1810-0694-2022-23-6-597-605
- Wang Z., Pan X., Xu H., Wu Y., Jia X., Fang Y. et al. Serum soluble ST2 Is a valuable prognostic biomarker in patients with acute heart failure. Front. Cardiovasc. Med. 2022; 9: 812654. DOI: 10.3389/fcvm.2022.812654
- Miftode R.-S., Constantinescu D., Cianga C.M., Petris A.O., Timpau A.-S., Crisan A. et al. A novel paradigm based on ST2 and its contribution towards a multimarker approach in the diagnosis and prognosis of heart failure: a prospective study during the pandemic storm. Life. 2021; 11: 1080. DOI: 10.3390/life11101080
- Hou Z.-W., Hai-bo Yu., Yan-chun Liang, Yang Gao, Guo-qing Xu., Min Wu. et al. Circulating soluble ST2 predicts all-cause mortality in severe heart failure patients with an implantable cardioverter defibrillator. Cardiol. Res. Pract. 2020; 2020: 4375651. DOI: 10.1155/2020/4375651
- Kompanets N.V., Aidumova O.Yu., Shchukin Yu.V. ST2 in heart failure with reduced and mid-range ejection fraction: clinical and instrumental relationships and prognostic value. Science and Innovations in Medicine. 2021; 6 (4): 55–8 (in Russ.). DOI: 10.35693/2500-1388-2021-6-4-55-58
About the authors
Rashid N. Songurov, Cardiologist;
ORCID