ST2 myocardial stress marker research in patients with obstructive sleep apnea and gastroesophageal reflux disease
DOI:
https://doi.org/10.14739/2310-1237.2020.1.203641Keywords:
obstructive sleep apnea, gastroesophageal reflux disease, ST2 marker of myocardial stress, myocardial disfunctionAbstract
Objective – To investigate the ST2 marker dynamics in the serum in patients with combined obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) and analyze its relationship with myocardial dysfunction.
Materials and methods. 135 patients were examined at the Educational and Scientific Medical Center of ZSMU “University Clinic”: group I – 31 patients with GERD, group II – 32 patients with OSA, group III – 72 patients with OSA and GERD. The control group consisted of 30 healthy individuals. The patients’ average age was 48 (36; 58) years. The groups were comparable by age, gender composition. The myocardial stress marker ST2 serum level was examined in all patients. The results of dispersive ECG mapping, daily monitoring of ECG and blood pressure, and echocardioscopy were evaluated.
Results. In patients with OSA and GERD combined course, 2-fold increase in the ST2 marker was detected compared with patients in the control group, with patients in group I – by 1.66 times, with patients in group II – by 1.36 times (P < 0.05). Significant correlation between ST2 level and the apnea-hypopnea index (ANI), heart rate variability parameters, the “Myocardium” index according to the dispersive ECG mapping and the left ventricular diastolic function parameters according to echocardioscopy was revealed.
Conclusions. Patients with a comorbid course of obstructive sleep apnea and gastroesophageal reflux disease have higher level of the ST2 marker. Serum ST2 concentration correlates with cardiovascular disorders in patients with combined OAS and GERD.
References
Weinberg, E. O., Shimpo, M., De Keulenaer, G. W., MacGillivray, C., Tominaga, S., Solomon, S. D., Rouleau, J. L., & Lee, R. T. (2002). Expression and regulation of ST2, an interleukin-1 receptor family member, in cardiomyocytes and myocardial infarction. Circulation, 106(23), 2961-2966. https://doi.org/10.1161/01.cir.0000038705.69871.d9
Nishimura, M., Brann, A., Chang, K.-W., & Maisel, A. S. (2018). The confounding effects of non-cardiac pathologies on the interpretation of cardiac biomarkers. Current Heart Failure Reports, 15(4), 239-249. https://doi.org/10.1007/s11897-018-0398-4
Aleksova, A., Paldino, A., Beltrami, A. P., Padoan, L., Iacoviello, M., Sinagra, G., Emdin, M., & Maisel, A. S. (2019). Cardiac Biomarkers in the Emergency Department: The Role of Soluble ST2 (sST2) in Acute Heart Failure and Acute Coronary Syndrome-There is Meat on the Bone. Journal of Clinical Medicine, 8(2), Article 270. https://doi.org/10.3390/jcm8020270
McCarthy, C. P., & Januzzi, J. L. (2018). Soluble ST2 in Heart Failure. Heart Failure Clinics, 14(1), 41-48. https://doi.org/10.1016/j.hfc.2017.08.005
Sozer, V., Kutnu, M., Atahan, E., Ozturk, B. C., Hysi, E., Cabuk, C., Musellim, B., Simsek, G., & Uzun, H. (2018). Changes in inflammatory mediators as a result of intermittent hypoxia in obstructive sleep apnea syndrome. Clinical Respiratory Journal, 12(4), 1615-1622. https://doi.org/10.1111/crj.12718
Shan, J., Oshima, T., Muto, T., Yasuda, K., Fukui, H., Watari, J., Nakanishi, K., & Miwa, H. (2015). Epithelial-derived nuclear IL-33 aggravates inflammation in the pathogenesis of reflux esophagitis. Journal of Gastroenterology, 50(4), 414-423. https://doi.org/10.1007/s00535-014-0988-1
Sateia, M. J. (2014). International Classification of Sleep Disorders-Third Edition Highlights and Modifications. Chest, 146(5), 1387-1394. https://doi.org/10.1378/chest.14-0970
Liu, L., Li, S., Zhu, K. X., Yu, W. H., Wang, H. J., Guo, J. Q., & Gao, H. W. (2019). Relationship between esophageal motility and severity of gastroesophageal reflux disease according to the Los Angeles classification. Medicine, 98(19), Article e15543. https://doi.org/10.1097/md.0000000000015543
Zharinov, O. Y., Ivaniv, Yu. A., & Kuts, V. O. (Eds.). (2018). Funktsionalna diahnostyka [Functional diagnostics]. Kyiv, Ukraine. [in Ukrainian].
Ivanov, G. G., Sula, A. S. (2014) Analiz mikroal'teratsii EKG metodom dispersionnogo kartirovaniya v klinicheskoi praktike [Analysis of ECG microalterations by the method of dispersion mapping in clinical practice]. Moscow, Russia: Tekhnosfera. [in Russian].
Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., Flachskampf, F. A., Foster, E., Goldstein, S. A., Kuznetsova, T., Lancellotti, P., Muraru, D., Picard, M. H., Rietzschel, E. R., Rudski, L., Spencer, K. T., Tsang, W., & Voigt, J. U. (2015). Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28(1), 1-U170. https://doi.org/10.1016/j.echo.2014.10.003
Khattak, H. K., Hayat, F., Pamboukian, S. V., Hahn, H. S., Schwartz, B. P., & Stein, P. K. (2018). Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis. Texas Heart Institute Journal, 45(3), 151-161. https://doi.org/10.14503/thij-15-5678
Dalal, J. J., Digrajkar, A., Das, B., Bansal, M., Toomu, A., & Maisel, A. S. (2018). ST2 elevation in heart failure, predictive of a high early mortality. Indian Heart Journal, 70(6), 822-827. https://doi.org/10.1016/j.ihj.2018.08.019
Lindam, A., Kendall, B. J., Thrift, A. P., Macdonald, G. A., O'Brien, S., Lagergren, J., & Whiteman, D. C. (2015). Symptoms of Obstructive Sleep Apnea, Gastroesophageal Reflux and the Risk of Barrett's Esophagus in a Population-Based Case-Control Study. Plos One, 10(6), Article e0129836. https://doi.org/10.1371/journal.pone.0129836
Mandal, S., & Kent, B. D. (2018). Obstructive sleep apnoea and coronary artery disease. Journal of Thoracic Disease, 10, S4212-S4220. https://doi.org/10.21037/jtd.2018.12.75
Farcas, A. D., Anton, F. P., Goidescu, C. M., Gavrila, I. L., Vida-Simiti, L. A., & Stoia, M. A. (2017). Serum Soluble ST2 and Diastolic Dysfunction in Hypertensive Patients. Disease Markers, Article 2714095. https://doi.org/10.1155/2017/2714095
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).