Serial sST2 dynamics after transcatheter tricuspid valve intervention: a candidate biomarker of biological response

AIMS: Patients undergoing transcatheter tricuspid valve intervention (TTVI) frequently present with advanced right-sided heart failure and multiorgan dysfunction, limiting the interpretability of conventional biomarkers such as natriuretic peptides. Soluble suppression of tumorigenicity 2 (sST2), a marker of myocardial strain, inflammation, and fibrosis, may provide complementary insight into biological response following intervention. PATIENTS & METHODS: In this prospective single-center cohort study, 135 patients undergoing TTVI were included. Plasma concentrations of sST2 were measured at baseline, discharge, 3 months, and 12 months. Longitudinal changes were analyzed using non-parametric repeated measures testing and compared with established biomarkers, including GDF-15, suPAR, H-FABP, NT-proANP and supplementary NT-proBNP analyses. This pattern remained consistent in sensitivity analyses. In contrast, GDF-15, suPAR, H-FABP, NT-proANP, and supplementary NT-proBNP analyses showed heterogeneous longitudinal profiles without the sustained treatment-related trajectory observed for sST2. CONCLUSIONS: In patients undergoing TTVI, sST2 exhibits a characteristic longitudinal profile reflecting biological response to intervention. These findings identify sST2 as a candidate dynamic biomarker and support a framework distinguishing prognostic baseline-risk biomarkers from dynamic treatment-response biomarkers.