TY - JOUR
T1 - Prediction of survival and magnitude of reverse remodeling using the ST2-R2 score in heart failure: A multicenter study
AU - Lupon, Josep
AU - Sanders-van Wijk, Sandra
AU - Januzzi, James L.
AU - de Antonio, Marta
AU - Gaggin, Hanna K.
AU - Pfisterer, Matthias
AU - Galan, Amparo
AU - Shah, Ravi
AU - Brunner-La Rocca, Hanspeter
AU - Bayes-Genis, Antoni
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background
Cardiac remodeling and its reversibility are key in HF outcomes.
The ST2-R2 score was recently developed to predict relevant left ventricular (LV) reverse remodeling (R2) in patients with heart failure (HF). In the present study we sought to validate the ST2-R2 score for grading improvement in LV ejection fraction (EF) and LV size at one year, and to evaluate its prognostic implication up to 4 years.
Methods
A total of 569 patients with baseline LVEF < 40% from three international cohorts (Barcelona, TIME-CHF, and PROTECT) were included in the study. Patients were classified into four strata based on their ST2-R2 score, which took into account concentrations of the biomarker ST2, non-ischemic etiology, absence of left bundle branch block, HF duration, baseline LVEF, and β-blocker treatment.
Results
A significant relationship was observed between ST2-R2 scores and changes in LVEF and indexed LV sizes. LVEF recovery (from + 5.6% to + 17.3%; p < 0.001), percentage reduction in LV end-systolic volume index (from − 6.1% to − 32.1%; p < 0.001) and in LV end-systolic diameter index (from − 1.1% to − 18.6%; p < 0.001) increased over the ST2-R2 strata. A similar trend was observed with diastolic parameters. Improvement in LV function and size was inversely predictive of mortality. Hazard ratios for risk of death, using the lower ST2-R2 score strata (< 9) as a reference, were 0.49 (p < 0.001; score 9–11), 0.27 (p < 0.001; score 12–14), and 0.17 (p < 0.001; score 15–17).
Conclusions
The ST2-R2 score predicts reverse LV remodeling in HF patients and is useful for predicting mortality up to 4 years.
AB - Background
Cardiac remodeling and its reversibility are key in HF outcomes.
The ST2-R2 score was recently developed to predict relevant left ventricular (LV) reverse remodeling (R2) in patients with heart failure (HF). In the present study we sought to validate the ST2-R2 score for grading improvement in LV ejection fraction (EF) and LV size at one year, and to evaluate its prognostic implication up to 4 years.
Methods
A total of 569 patients with baseline LVEF < 40% from three international cohorts (Barcelona, TIME-CHF, and PROTECT) were included in the study. Patients were classified into four strata based on their ST2-R2 score, which took into account concentrations of the biomarker ST2, non-ischemic etiology, absence of left bundle branch block, HF duration, baseline LVEF, and β-blocker treatment.
Results
A significant relationship was observed between ST2-R2 scores and changes in LVEF and indexed LV sizes. LVEF recovery (from + 5.6% to + 17.3%; p < 0.001), percentage reduction in LV end-systolic volume index (from − 6.1% to − 32.1%; p < 0.001) and in LV end-systolic diameter index (from − 1.1% to − 18.6%; p < 0.001) increased over the ST2-R2 strata. A similar trend was observed with diastolic parameters. Improvement in LV function and size was inversely predictive of mortality. Hazard ratios for risk of death, using the lower ST2-R2 score strata (< 9) as a reference, were 0.49 (p < 0.001; score 9–11), 0.27 (p < 0.001; score 12–14), and 0.17 (p < 0.001; score 15–17).
Conclusions
The ST2-R2 score predicts reverse LV remodeling in HF patients and is useful for predicting mortality up to 4 years.
KW - Heart failure
KW - Reverse remodeling
KW - LVEF
KW - Biomarkers
KW - ST2
KW - Survival
U2 - 10.1016/j.ijcard.2015.11.163
DO - 10.1016/j.ijcard.2015.11.163
M3 - Article
C2 - 26682955
SN - 0167-5273
VL - 204
SP - 242
EP - 247
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -