Relationship between serum soluble suppression of tumorigenicity (ST) 2 and global longitudinal strain in early onset preeclampsia

Abstract

Background: Early onset preeclampsia, defined as preeclampsia that occurs before 34th weeks, has a higher cardiovascular events due to higher cytokine concentrations. Hemodynamic changes in preeclampsia can trigger cardiac remodeling as indicated by increase of soluble-ST2 (sST2). Global longitudinal strain were able to detect systolic dysfunction better than the ejection fraction. This study aims to evaluate the correlation between serum levels of sST2 towards GLS in patients with early-onset preeclampsia. Methods: This is a cross-sectional observational study with correlation analysis. Subjects were patients with severe preeclampsia with gestational age before 34 weeks at Dr. Hasan Sadikin Bandung and Bandung Kiwari Regional General Hospital from June to August 2022. Examination of sST2 was carried out through blood samples using the ELISA method. sST2 was measured using Presage ST2 Assay reagent. GLS examination was carried out using speckle tracking technique with EchoPAC. Correlation analysis was conducted using the Pearson test if normally distributed, otherwise Spearman's correlation was conducted. Correlation analysis was followed by linear regression. Results: A total of 30 patients met the inclusion criteria. The mean age was 30.83 ± 7.09, with 17 (56.7%) multiparous patients. The median sST2 was 145.75 ng/mL, and the median GLS was -17.4%. Spearman correlation analysis showed that there was a significant negative correlation with moderate strength between sST2 and GLS (r=0.583; p<0.002). Linear regression showed that every 1 ng/ml increase in sST2 would give a decrease in GLS of 0.014%. Conclusion: There is a significant correlation between sST2 and GLS in patients with early onset severe preeclampsia.