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St2 in patients with severe aortic stenosis and heart failure

Research output: Contribution to journalArticlepeer-review

Andrew Cai, Alejandra Miyazawa, Nicholas Sunderland, Susan E. Piper, Thomas G.J. Gibbs, Duolao Wang, Sadie Redding, George Amin-Youseff, Olaf Wendler, Jonathan Byrne, Philip A. Maccarthy, Ajay M. Shah, Theresa A. McDonagh, Rafal Dworakowski

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalCardiology Journal
Issue number1

Bibliographical note

Funding Information: This work was funded by King’s College Hospital R&D Grant, and was supported by the Department of Health via a National Institute for Health Research Biomedical Research Centre award to Guy’s & St. Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust Publisher Copyright: © 2021 Via Medica. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


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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