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  • Title: ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: A cardiac magnetic resonance study.
    Author: Miñana G, Núñez J, Bayés-Genís A, Revuelta-López E, Ríos-Navarro C, Núñez E, Chorro FJ, López-Lereu MP, Monmeneu JV, Lupón J, Bodí V.
    Journal: Int J Cardiol; 2018 Nov 01; 270():336-342. PubMed ID: 29954670.
    Abstract:
    BACKGROUND: The association of soluble interleukin-1 receptor-like 1 (ST2) with left ventricular (LV) remodeling is unclear in patients with a first ST-segment elevation myocardial infarction (STEMI). The objective of this work was to assess the relationship between ST2, a marker of inflammation, and cardiac magnetic resonance (CMR) imaging-derived LV remodeling after a first STEMI. METHODS: We prospectively evaluated 109 patients with a first STEMI treated with primary percutaneous coronary intervention who had ST2 assessed 24 h post-reperfusion. All patients underwent CMR imaging 1 week and 6 months after STEMI. The independent associations between ST2, LV diastolic and systolic volume indices, and LV ejection fraction (LVEF) were evaluated by linear mixed models. RESULTS: The mean age of the sample was 59 ± 12 years, 85 patients (78%) were male, and 13 (11.9%) had a LVEF ≤40%. The median (IQR) of ST2 was 55.3 (38.7-94.1) pg/mL. At 1-week CMR higher ST2 was related to more infarct size and less myocardial salvage index (p < 0.01). Overall, after comprehensive multivariable adjustment, higher baseline ST2 was associated with progressive LV volume indices dilation and LVEF deterioration (p < 0.05). This effect was stronger in patients with severe 1-week structural damage, namely those with large infarct size, extensive microvascular obstruction or LVEF ≤40%. CONCLUSIONS: In patients with a first STEMI treated with primary percutaneous coronary intervention, soluble ST2 predicts dynamic changes in CMR-derived LV volumes and LVEF. Future studies must assess whether targeting interleukin-1 leads to lower ST2 levels and less LV remodeling.
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