Soluble ST2 as a dynamic biomarker of biological response after transcatheter tricuspid valve intervention
C Edlinger, J Schlegl, M Bannehr, M Lichtenauer, T Kuecken, Alexaner Krutz, V Paar, M Neuss, A Haase-Fielitz, C ButterAbstract
Background
Biomarker trajectories following transcatheter tricuspid valve intervention (TTVI) remain insufficiently characterized. Interpretation of natriuretic peptides in this population is challenging due to frequent renal dysfunction and cardiorenal syndrome. Soluble ST2 (sST2) provides prognostic information independent of renal function and natriuretic peptides. Complementary biomarkers reflecting systemic stress, inflammation, and myocardial injury were assessed in parallel to contextualize biological response after TTVI.
Purpose
To characterize serial changes of sST2 and compare its longitudinal dynamics with other stress and inflammation biomarkers after TTVI.
Methods
In a prospective single-centre cohort, 135 patients undergoing TTVI were included. sST2, GDF-15, suPAR, H-FABP, and NT-proANP were measured at baseline, discharge, 3 months, and 12 months. Longitudinal changes were analysed using paired non-parametric comparisons.
Results
The cohort was elderly (median age 82 years), with high prevalence of atrial fibrillation and advanced right heart failure.
sST2 exhibited a distinct biphasic trajectory, with significant increase from baseline to discharge (n=135; p=0.004), followed by significant reduction at 3 months (n=124; p=0.003) and sustained decline at 12 months (n=82; p<0.0001).GDF-15 showed no significant longitudinal change. suPAR demonstrated early reduction at discharge (p<0.001) and 3 months (p=0.004), without sustained decline at 12 months (p=0.895). H-FABP decreased only at 12 months (p=0.007), whereas NT-proANP showed no consistent dynamic pattern.
Conclusion
Among the biomarkers assessed, sST2 exhibited the most consistent longitudinal trajectory following TTVI. This dynamic pattern suggests potential utility for monitoring biological response in this population and warrants further validation in independent cohorts.Table1For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.