Vol 28, No 1 (2021)
Original Article
Published online: 2019-05-29

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ST2 in patients with severe aortic stenosis and heart failure

Andrew Cai1, Alejandra Miyazawa2, Nicholas Sunderland1, Susan E. Piper1, Thomas G.J. Gibbs1, Duolao Wang3, Sadie Redding1, George Amin-Youseff1, Olaf Wendler1, Jonathan Byrne1, Philip A. MacCarthy1, Ajay M. Shah4, Theresa A. McDonagh4, Rafał Dworakowski1
Pubmed: 31225635
Cardiol J 2021;28(1):129-135.


Background: ST2 is a circulating biomarker that is well established for predicting outcome in heart failure (HF). This is the first study to look at ST2 concentrations in optimally treated patients with stable but significant left ventricular systolic dysfunction (LVSD) compared to patients with severe aortic stenosis (AS).

Methods: Two cohorts were retrospectively studied: 94 patients undergoing transcatheter aortic valve
implantation for severe AS (63 with normal ejection fraction [EF] and 31 with reduced EF), and 50 patients with severe LVSD from non-valvular causes. ST2 pre-procedural samples were taken, and repeated again at 3 and 6 months. Patients were followed-up for 2 years. Data was analyzed using SPSS software.

Results: Baseline concentrations of soluble ST2 did not differ significantly between the HF group and AS group with normal EF (EF ≥ 50%). However, in the AS group with a low EF (EF < 50%) ST2 concentrations
were significantly higher that the HF group (p = 0.009). New York Heart Association class IV HF, baseline N-terminal pro-B-type natriuretic peptide and gender were all independent predictors of soluble ST2 (sST2) baseline concentrations.

Conclusions: Raised ST2 concentrations in the context of severe AS may be a marker for subclinical or clinical left ventricular dysfunction. More research is required to assess its use for assessment of prognosis and response to treatment.

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