The levels and significance of soluble ST2 and galectin-3 in patients with dilated cardiomyopathy

Objective The study aimed to investigate the clinical value of serum soluble ST2(sST2) and galectin-3(gal-3) in dilated cardiomyopathy(DCM) patients associated with heart failure. Methods 60 DCM patients with heart failure were collected in Anzhen Hospital Department of Cardiology from June to December 2017 as researching group. 52 coronary heart disease(CHD) patients with heart failure were as the controls, also, 70 healthy controls were analyzed by cross-sectional investigation. In DCM group, 18 patients (male/female:11/7) were enrolled in the NYHA(New York Heart Association) cardiac function Ⅰ-Ⅱ group and 42 patients (male/female: 32/10) were enrolled in the NYHA cardiac function Ⅲ-Ⅳ group. sST2 was detected by enzyme-linked immunoassay; gal-3 was detected by chemiluminescence immunoassay. One-Way ANOVA, non-parametric test, Spearman linear correlation analysis and other statistical methods were used in our study. Results Compared with healthy controls, the serum level of sST2 in DCM group increased markedly [21.23(14.59,25.29) ng/ml vs 14.59(12.78,17.16) ng/ml, standardized H=-4.645,adjusted P<0.001], and significantly higher serum level of gal-3 [13.50(10.48,19.68)μg/L vs 10.05(8.25, 12.80) μg/L, standardized H=4.266, adjusted P<0.001]. Compared with CHD group, there was a significant increase [13.50(10.48, 19.68) μg/L vs 11.00(8.65, 13.58) μg/L, standardized H=-2.715, adjusted P=0.020] in the expression of serum gal-3 in DCM group. The serum level of sST2 in cardiac function Ⅲ-Ⅳ group was obviously higher than that in the Ⅰ-Ⅱ group [22.54(16.82,26.78)ng/ml vs 12.24(9.22,17.79) ng/ml, Z=2.613,P=0.009].Spearman correlation analysis showed a negative correlation between sST2 and left ventricular ejection fraction(LVFE)(r=-0.647, P<0.01), but a positive correlation between left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic dimension(LVESD)(r=0.393,r=0.462,all P<0.01). The correlation of sST2 and B-type natriuretic peptide(BNP)/gal-3 (r=0.320,r=0.331,all P<0.05),gal-3 and high-sensitivity troponinI(hs-TnI)/BNP(r=406,r=0.401,all P≤0.01) presented the same. There was a inverse correlation between gal-3 and estimated glomerular filtration rate(eGFR)(r=-0.326,P<0.05).ROC analysis showed that the cutoff of sST2 was 21.00 ng/ml, with 51.9% sensitivity and 95.7% specificity (AUC=0.745,95% CI:0.652-0.838,P<0.001), and the cutoff of gal-3 was 13.15 μg/L, with 53.7% sensitivity and 85.7% specificity (AUC=0.720,95% CI:0.627-0.812,P<0.001). Combined detection of BNP/hs-TnI may remarkably improved the sensitivity (up to 95.3%). Conclusions The serum levels of sST2 and gal-3 were significantly increased in dilated cardiomyopathy patients with heart failure. It showed a strong relation between sST2 and the deterioration of cardiac function, and a certain correlation with left ventricular remodeling. Although the diagnostic value of DCM was lower than that of BNP, sST2 may not be affected by age, body mass index and the damage to kidney function. Combined diagnosis could dramatically improve the diagnostic efficacy. Key words: Cardiomyopathy, dilated; Interleukin-1 receptor-like 1 protein; Galectin 3