DIAGNOSTIC VALUE OF SERUM SST2 IN ELDERLY HYPERTENSION WITH LEFT VENTRICULAR HYPERTROPHY AND ASSESSMENT OF LEFT VENTRICULAR HYPERTROPHY SEVERITY

Xueyong Wan^*, Yiping Wen, Wangsheng Cheng, Shengfeng Lan, Musheng Liu

Jingdezhen Second People's Hospital, Jingdezhen 333000, PR China

Objective: To analyze the value of serum soluble ST2 (sST2) in the diagnosis of hypertension (HP) complicated with left ventricular hypertrophy (LVH) and to evaluate the severity of left ventricular hypertrophy in the elderly. 

Methods: Two hundred and four elderly patients with hypertension treated in our hospital from January 2019 to January 2020 were collected, and the patients were divided into the LVH group (n=68), the early LVH group (n=73), and the early HP group (63). The levels of left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWTD), and end-diastolic ventricular septal thickness (IVSTD) were measured by echocardiography. Four ml of fasting venous blood were collected from each group, then serum levels of sST2, Galectin-3, and transforming growth factor β1(TGF-β1) were detected by enzyme linked immunosorbent assay. Serum indexes of patients in each group were compared. Pearson's linear correlation analysis was used to analyze the correlation between sST2, Galectin-3, and TGF- 1 and LVMI. Moreover, ROC curve was used to examine the value of sST2, Galectin-3, and TGF- 1 in the diagnosis of hypertensive patients with left ventricular hypertrophy. 

Results: The levels of LVDD, LVPWTD, and IVSTD in the LVH group were significantly higher than those in the early LVH group and the simple HP group. Additionally, IVSTD levels in the early LVH group were considerably higher than those in the simple HP group, with statistically significant differences (P<0.05). There was no significant difference in LVDD or LVPWTD between the early LVH group and the simple HP group (P>0.05). The serum levels of sST2, Galectin-3, and TGF- 1 in the LVH group and the early LVH group were notably higher than those in the HP group alone. Furthermore, the serum levels of sST2, Galectin-3, and TGF- 1 in the LVH group were significantly higher than those in the early LVH group, with statistically significant differences (P<0.05). Pearson linear correlation analysis showed that LVMI was positively correlated with sST2, Galectin-3, and TGF- 1 (R=0.335, 0.156 and 0.286, P<0.05 or <0.01, respectively). ROC curve analysis showed that the AUC, sensitivity, and specificity of sST2 in diagnosing left ventricular hypertrophy in elderly patients with hypertension were 0.859, 86.37%, and 82.17%, respectively. The AUC, sensitivity, and specificity of GALectin-3 in diagnosing left ventricular hypertrophy in elderly patients with hypertension were 0.712, 75.34%, and 71.04%, respectively. The AUC, sensitivity, and specificity of TGF- 1 in diagnosing left ventricular hypertrophy in elderly patients with hypertension were 0.723, 69.58%, and 70.24%, respectively. 

Conclusion: The levels of sST2, Galectin-3, and TGF- 1 were significantly higher in elderly patients with HP combined with LVH and increased with the aggravation of the severity of LVH. The three levels were positively correlated with LVMI and had a particular value in the diagnosis of HP combined with LVH in the elderly. Furthermore, sST2 had the highest diagnostic value and could be widely used in clinical practice.