Plasma concentrations soluble ST2 and сardiac dysfunction in patients with essential hypertension

Abstract

The aim – to determine the place of soluble ST2 (sST2) as a possible biomarker of remodeling and heart dysfunction in patients with essential hypertension of varying severity.Materials and methods. Examined 150 men with confirmed essential hypertension (EН) of varying severity, including 50 people with EН complicated by heart failure (HF) IIA stage according to the classification of UAHF (groups were representative by age, mean age 50.17±0.48 y.о.), 70 men in the control group (mean age 48.82±0.78 y.о.) The following inclusion criteria were used: age 40 to 60 years, male, verified diagnosis of EH. The structure and function of the heart were studied using echocardiography with Doppler. The serum level of sST2 was determined by immuno assay.Results and discussion. The serum level of sST2 in patients of the control group was 22.14±0.86 ng/ml. It was found, that the peptide concentration in plasma of male patients without cardiovascular disease does not significantly correlate with physical or age parameters, renal function, the condition of systemic or intracardiac hemodynamics. It was found, that for patients with EH the serum level of sST2 was significantly higher than in the control group (p<0.05). The formation of left ventricular hypertrophy (LVH) leads to a significant increase of the peptide concentration in plasma in patients with EH. However, in patients with different types of LVH – concentric and eccentric – the indicator does not differ significantly (26.87±1.04 ng/ml vs. 29.15±1.15 ng/ml, p≥0.05). It was determined, that in case of confirmed diastolic dysfunction (DD) without LVH, the level of the peptide does not increase significantly. And only in patients with a combination of DD and LVH the serum level of sST2 is significantly higher (27.64±1.17 ng/ml, p≥0.05). Also in patients with EH and left ventricular ejection fraction (LV EF) less than 40 %, the serum level of peptide is significantly higher, than in patients with preserved LV EF (25.65±1.14 ng/ml vs. 29.07±1.22 ng/ml, p≥0.01).Conclusions. Thus, in male patients with EH of varying severity, the serum level of sST2 is significantly higher than in people without cardiovascular disease. Peptide concentration in plasma in both cases is not related to age or physical parameters. In patients with uncomplicated EH, significantly higher serum level of sST2 ​​is associated with the development of LVH, regardless of its type, and impaired diastolic function of the heart. In case of HF on the background of EH, the serum level of sST2 also is significantly higher, especially in case of the formation of systolic heart dysfunction with LV FE < 40 %.