Key result
Elevated sST2 levels independently predicted diffuse myocardial fibrosis (OR 1.154; 95% CI 1.021-1.305; P=0.022) and focal myocardial fibrosis in patients with idiopathic inflammatory myopathies.
Why the study?
Myocardial fibrosis develops during the early subclinical stage of cardiac involvement in idiopathic inflammatory myopathies, but the diagnostic value of sST2 for detecting it remained unknown.
Does serum sST2 predict myocardial fibrosis detected by CMR in patients with idiopathic inflammatory myopathies in the subclinical stage?
Case-Control (n=76)
Does serum sST2 predict myocardial fibrosis detected by CMR in patients with idiopathic inflammatory myopathies in the subclinical stage?
Odds Ratio: 1.154 (95% CI 1.021–1.305)
p-value: p=0.022
Serum sST2 is significantly elevated in the subclinical stage of cardiac involvement in idiopathic inflammatory myopathies and demonstrates high diagnostic accuracy for predicting diffuse and focal myocardial fibrosis.
sST2 may aid early fibrosis detection in IIM with normal function; leaves open clinical adoption pending validation.
OBJECTIVE: Myocardial fibrosis occurs in the early subclinical stage of cardiac involvement in idiopathic inflammatory myopathies (IIMs). Soluble suppression of tumorigenicity 2 (sST2) is known to have an immunomodulatory impact during autoimmune disease development. The current study investigated the diagnostic value of sST2 for myocardial fibrosis during early stage of cardiac involvement in IIM. METHODS: A total of 44 IIM patients with normal heart function and 32 age- and gender-matched healthy controls (HCs) were enrolled. Serum sST2 levels were measured by ELISA and cardiac magnetic resonance (CMR) parameters for myocardial fibrosis [native T1, extracellular volume (ECV), late-gadolinium enhancement (LGE)] and oedema (T2 values) were analysed. RESULTS: IIM patients had significantly higher sST2 levels than HCs [67.5 ng/ml (s.d. 30.4)] vs 14.4 (5.5), P < 0.001] and levels correlated positively with diffuse myocardial fibrosis parameters, native T1 (r = 0.531, P = 0.000), ECV (r = 0.371, P = 0.013) and focal myocardial fibrosis index and LGE (r = 0.339, P = 0.024) by Spearman's correlation analysis. sST2 was an independent predictive factor for diffuse and focal myocardial fibrosis after adjustment for age, gender, BMI and ESR. Risk increased ≈15.4% for diffuse [odds ratio (OR) 1.154 (95% CI 1.021, 1.305), P = 0.022] and 3.8% for focal [OR 1.038 (95% CI 1.006, 1.072), P = 0.020] myocardial fibrosis per unit increase of sST2. Cut-off values for diagnosing diffuse and focal myocardial fibrosis were sST2 ≥51.3 ng/ml [area under the curve (AUC) = 0.942, sensitivity = 85.7%, specificity = 98.9%, P < 0.001] and 53.3 ng/ml (AUC = 0.753, sensitivity = 87.5%, specificity = 58.3%, P < 0.01), respectively. CONCLUSION: sST2 showed a marked elevation during the subclinical stage of cardiac involvement in IIM and has potential as a biomarker for predicting diffuse and focal myocardial fibrosis in IIM.
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Sun et al. (2023) conducted a case-control in Idiopathic inflammatory myopathies (IIMs) (n=76). sST2 levels vs. Healthy controls / lower sST2 levels was evaluated on Diffuse myocardial fibrosis (OR 1.154, 95% CI 1.021-1.305, p=0.022). Elevated sST2 levels independently predicted diffuse myocardial fibrosis (OR 1.154; 95% CI 1.021-1.305; P=0.022) and focal myocardial fibrosis in patients with idiopathic inflammatory myopathies.
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