Relationship between Serum Soluble Suppression of Tumorigenicity (ST) 2 and Global Longitudinal Strain in Pre-eclampsia at Delivery and 1 Year After

Mohammad Rizki Akbar; Muhammadnur Rachim Enoch; Rien Afrianti; Prameswari Hawani Sasmaya; Achmad Fitrah Khalid; Dewi Anggraeni; Michael Aditya Lesmana

doi:10.3889/oamjms.2022.8764

Authors

Mohammad Rizki Akbar Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Muhammadnur Rachim Enoch Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Rien Afrianti Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Prameswari Hawani Sasmaya Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Achmad Fitrah Khalid Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Dewi Anggraeni Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
Michael Aditya Lesmana Department of Cardiology, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8764

Keywords:

Global longitudinal strain, Pre-eclampsia, Soluble ST2, Postpartum

Abstract

BACKGROUND: Pre-eclampsia is characterized by severe inflammatory response and endothelial dysfunction that could lead to myocardial injury and remodeling. Biomarker examination such as soluble Suppression of Tumorigenicity 2 (sST2), which has been used as a marker for myocardial fibrosis and Global Longitudinal Strain (GLS) by echocardiography could be used to predict mortality and detect subclinical myocardial dysfunction.

AIM: The purpose of this study was to determine the correlation between serum levels of sST2 and GLS in patients with pre-eclampsia 1 year postpartum.

METHODS: This was a cross-sectional study with correlation analysis. GLS examination was done using EchoPAC workstation. Maternal plasma of sST2 was measured using the Presage ST2 Assay. Rank-Spearman correlation analysis was conducted to analyze the correlation between GLS and sST2 at delivery and 1 year postpartum.

RESULTS: There were 30 subjects with pre-eclampsia who fulfilled the criteria. Average age was 33 ± 6 years and majority were multipara (76.7%) and early onset pre-eclampsia (76.7%) with sST2 value of 66.1 ± 7.7 ng/mL and GLS of −17 ± 0.4%. One year after delivery, the sST2 value is 22 ± 1.4 ng/mL and an average value GLS is −19.7 ± 0.4%. Analysis showed moderate positive correlation between sST2 and GLS at delivery (r = 0.439, p = 0.015), but there was no correlation between sST2 and GLS 1 year after delivery (r = 0.036, p = 0.961).

CONCLUSIONS: This study demonstrates a significant correlation between sST2 and GLS at delivery in patients with pre-eclampsia but not in 1 year after delivery.

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References

Gathiram P, Moodley J. Pre-eclampsia: Its pathogenesis and pathophysiolgy. Cardiovascular J Africa. 2016;27:71-8. https://doi.org/10.5830/CVJA-2016-009 PMid:27213853

Wantania J, Attamimi A, Siswishanto R. A comparison of 2-methoxyestradiol value in women with severe preeclampsia versus normotensive pregnancy. J Clin Diagn Res. 2017;11:QC35-8. https://doi.org/10.5830/CVJA-2016-009 Mid:28511459 DOI: https://doi.org/10.5830/CVJA-2016-009

Cunningham G, Leveno K, Bloom S, Dashe J, Hoffman B, Casey B , et al. Williams Obstetrics. 25th ed. New York: McGraw- Hill Education; 2018.

Melchiorre K, Sharma R, Thilaganathan B. Cardiovascular implications in preeclampsia: An overview. Circulation. 2014;130:703-14. https://doi.org/10.1161/CIRCULATIONAHA.113.003664 PMid:25135127 DOI: https://doi.org/10.1161/CIRCULATIONAHA.113.003664

Fabiani I, Pugliese NR, Santini V , et al. Speckle-tracking imaging, principles and clinical applications: A review for clinical cardiologists. In: Echocardiography in Heart Failure and Cardiac Electrophysiology. London: InTech; 2016. DOI: https://doi.org/10.5772/64261

Shahul S, Rhee J, Hacker MR, Gulati G, Mitchell JD, Hess P, et al. Subclinical left ventricular dysfunction in preeclamptic women with preserved left ventricular ejection fraction: A 2D speckle-tracking imaging study. Circ Cardiovasc Imaging. 2012;5:734-9. https://doi.org/10.1161/CIRCIMAGING.112.973818 PMid:22891044 DOI: https://doi.org/10.1161/CIRCIMAGING.112.973818

Nouh S, al Deftar-Maged H, Sisi M. Assessment of left ventricular function in preeclamptic women with preserved left ventricular ejection fraction using two dimensional speckle tracking imaging. N Y Sci J. 2016;9:32-9.

Shahul S, Ramadan H, Mueller A, Nizamuddin J, Nasim R, Perdigao JL, et al. Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia. Pregnancy Hypertens. 2017;10:251-5. https://doi.org/10.1016/j.preghy.2017.10.009 PMid:29111424 DOI: https://doi.org/10.1016/j.preghy.2017.10.009

Paudel A, Tigen K, Yoldemir T, Guclu M, Yildiz I, Cincin A, et al. The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients. Int J Cardiovasc Imaging. 2020;36:1689-94. https://doi.org/10.1007/s10554-020-01872-y PMid:32388817 DOI: https://doi.org/10.1007/s10554-020-01872-y

Gruson D, Ahn S, Rousseau M. Biomarkers of inflammation and cardiac remodeling: The quest of relevant companions for the risk stratification of heart failure patients is still ongoing. Biochem Med (Zagreb). 2011;21:254-63. http://doi.10.11613/bm.2011.035 PMid:22420239

Chen WY, Hong J, Gannon J, Kakkar R, Lee RT. Myocardial pressure overload induces systemic inflammation through endothelial cell IL-33. Proc Natl Acad Sci U S A. 2015;112:7249-54. https://doi.org/10.1073/pnas.1424236112 PMid:25941360 DOI: https://doi.org/10.1073/pnas.1424236112

Mueller T, Jaffe AS. Soluble ST2 - Analytical considerations. Am J Cardiol. 2015;115:8B-21B. https://doi.org/10.1016/j.amjcard.2015.01.035 PMid:25697919 DOI: https://doi.org/10.1016/j.amjcard.2015.01.035

Bayes-Genis A, de Antonio M, Vila J, Peñafiel J, Galán A, Barallat J, et al. Head-to-head comparison of 2 myocardial fibrosis biomarkers for long-term heart failure risk stratification: ST2 versus galectin-3. J Am Coll Cardiol. 2014;63:158-66. https://doi.org/10.1016/j.jacc.2013.07.087 PMid:24076531 DOI: https://doi.org/10.1016/j.jacc.2013.07.087

Granne I, Southcombe JH, Snider JV, Tannetta DS, Child T, Redman CW, et al. ST2 and IL-33 in pregnancy and pre-eclampsia. PLoS One. 2011;6:e24463. https://doi.org/10.5830/CVJA-2016-00910.1371/journal.pone.0024463 PMid:21949719 DOI: https://doi.org/10.1371/journal.pone.0024463

Romero R, Chaemsaithong P, Tarca AL, Korzeniewski SJ, Maymon E, Pacora P, et al. Maternal plasma-soluble ST2 concentrations are elevated prior to the development of early and late onset preeclampsia – A longitudinal study. J Maternal Fetal Neonatal Med. 2018;31:418-32. https://doi.org/10.1080/14767058.2017.1286319 PMid:28114842 DOI: https://doi.org/10.1080/14767058.2017.1286319

Mugerli S, Ambrožič J, Geršak K, Lučovnik M. Elevated soluble-St2 concentrations in preeclampsia correlate with echocardiographic parameters of diastolic dysfunction and return to normal values one year after delivery. J Maternal Fetal Neonatal Med. 2021;34:379-85. https://doi.org/10.1080/14767058.2019.1609934 PMid:31056999 DOI: https://doi.org/10.1080/14767058.2019.1609934

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1-39.e14. https://doi.org/10.1016/j.echo.2014.10.003 PMid:25559473 DOI: https://doi.org/10.1016/j.echo.2014.10.003

Mukaka MM. Statistics Corner: A Guide to Appropriate Use of Correlation Coefficient in Medical Research; 2012. http://www.mmj.medcol.mw. [Last accessed on 2022 Mar 15].

Melchiorre K, Thilaganathan B. Maternal cardiac function in preeclampsia. Curr Opin Obstetr Gynecol. 2011;23:440-7. https://doi.org/10.1097/GCO.0b013e32834cb7a4 PMid:21986727 DOI: https://doi.org/10.1097/GCO.0b013e32834cb7a4

Sasmaya PH, Khalid AF, Anggraeni D, Irianti S, Akbar MR. Differences in maternal soluble ST2 levels in the third trimester of normal pregnancy versus preeclampsia. Eur J Obstet Gynecol Reprod Biol X. 2021;13:100140. https://doi.org/10.1016/j.eurox.2021.100140 PMid:34917932 DOI: https://doi.org/10.1016/j.eurox.2021.100140

Maharani L, Wibowo N. Soluble growth stimulation gene-2 level on severe preeclampsia patients without and with complications. J SAFOG. 2018;10:123-6. DOI: https://doi.org/10.5005/jp-journals-10006-1573

Cho KI, Kim SM, Shin MS, Kim EJ, Cho EJ, Seo HS, et al. Impact of gestational hypertension on left ventricular function and geometric pattern. Circ J. 2011;75:1170-6. https://doi.org/10.1253/circj.cj-10-0763 PMid:21389638 DOI: https://doi.org/10.1253/circj.CJ-10-0763

Amaral LM, Cunningham MW, Cornelius DC, LaMarca B. Preeclampsia: Long-term consequences for vascular health. Vascu Health Risk Manag. 2015;11:403-15. https://doi.org/10.2147/VHRM.S64798 PMid:26203257 DOI: https://doi.org/10.2147/VHRM.S64798

Cheng S, Shah AM, Albisu JP, Desai AS, Hilkert RJ, Izzo J, et al. Reversibility of left ventricular mechanical dysfunction in patients with hypertensive heart disease. J Hypertens. 2014;32:2479-87. http://doi.10.1097/HJH.0000000000000340 PMid:25232755

Fabiani I, Conte L, Pugliese NR, Calogero E, Barletta V, Di Stefano R, et al. The integrated value of sST2 and global longitudinal strain in the early stratification of patients with severe aortic valve stenosis: A translational imaging approach. Int J Cardiovasc Imaging. 2017;33:1915-20. https://doi.org/10.1007/s10554-017-1203-2 PMid:28664478 DOI: https://doi.org/10.1007/s10554-017-1203-2