The Relationship Between Levels Of Serum SST-2,Gal-3 And Myocardial Fibrosis In Patients With Dilated Cardiomyopathy

Objective:To investigate the levels of serum soluble tumor suppressor-2(sST-2)and galectin-3(Gal-3)in patients with dilated cardiomyopathy(DCM)and their impact on myocardial fibrosis,and explore the clinical value of sST-2 and Gal-3 to evaluate the degree of myocardial fibrosis in patients with DCM.Methods:From June 2018 to December 2019 in Yan'an Hospital affiliated to Kunming Medical University in geriatrics department and cardiology department,53 DCM inpatients were enrolled as DCM group(30 males and 23 females,aged 55.09±8.31 years).Identified by LGE-CMR,DCM group was divided into DCM-LGE(+)group and DCM-LGE(-)group,and DCM-LGE(+)group includes 30 subjects(18 males and 12 females,aged 55.07±9.18 years),DCM-LGE(-)group includes 23 subjects(12 males and 11 females,aged 55.13±7.23 years).16 outpatients without basic heart disease in the same period were enrolled as control group(9 males and 7 females,aged 54.81±10.28 years).The levels of sST-2 and Gal-3 among all subjects were tested by ELISA.Additionally,the general data of all groups including BNP?LVEF?LVESD?LVEDD?BNP and so on were collected.Statistical analyses were performed using SPSS software finally.Results:1.Compared with the control group,there were increases in DCM group of sST-2,Gal-3,BNP,hs-CRP,LVEDD as well as LVESD and decrease of LVEF(P<0.01).There were no differences in age,BMI,SBP,DBP,FBG,LDL-C,UA,TC and TG between the DCM group and the control group(P>0.05).2.Compared with DCM-LGE(-)group,there were increases in the DCM-LGE(+)group of sST-2,Gal-3 as well as hs-CRP and decrease of LVEF(P<0.01).There were no differences in LVESD,LVEDD and BNP between these two groups(P>0.05);Compared with the control group,there were increases in DCM-LGE(+)group of sST-2,Gal-3,BNP,hs-CRP,LVESD as well as LVEDD and decrease of LVEF(P<0.01);Compared with the control group,there were increases in DCM-LGE(-)group of sST-2,Gal-3,BNP,hs-CRP,LVESD as well as LVEDD and decrease of LVEF(P<0.01);There were no differences in age,BMI,SBP,DBP,FBG,LDL-C,UA,TC and TG among these groups(P>0.05).3.sST-2 was negatively correlated with LVEF(r=-0.662,P<0.01)while positively correlated with LVESD,LVEDD and BNP(r=0.651;r=0.398;r=0.485,P<0.01).Gal-3 was negatively correlated with LVEF(r=-0.705,P<0.01)while positively correlated with LVESD,LVEDD and BNP(r=0.768;r=0.490;r=0.518,P<0.01).sST-2 was positively correlated with Gal-3(r=0.658,P<0.01).4.1n DCM group,setting LGE(+)as state variable.When setting sST-2 as test variable,AUC was 0.776(P<0.001),the cut-point was 22.5ng/ml(sensitivity was 76.7%and specificity was 65.2%).When setting Gal-3 as test variable,AUC was 0.967(P<0.001),the cut-point was 20.5ng/ml(sensitivity was 83.3%and specificity was 95.7%),AUCsST-2<AUCGal-3.Conclusions:1.The levels of serum sST-2 and Gal-3 increased in patients with DCM compared with the control group.2.There were increases of the levels of serum sST-2 and Gal-3 in LGE(+)DCM patients.Serum sST-2 and Gal-3 may be used as indexes to evaluate the degree of myocardial fibrosis in patients with DCM.3.Serum sST-2 and Gal-3 was negatively correlated with LVEF while positively correlated with LVEDD,LVESD and BNP.Serum sST-2 and Gal-3 may be related to ventricular remodeling and heart failure,and they may have some clinical value in prognosis assessment.4.When serum sST-2?22.5ng/ml,the sensitivity was 76.7%and the specificity was 65.2%.When serum Gal-3?20.5ng/ml,the sensitivity was 83.3%and the specificity was 95.7%.The two cut-points may be referential threshold values for degree evaluation of myocardial fibrosis in patients with DCM.