Effect of β-Blocker Therapy on the Level of Soluble ST2 Protein in Pediatric Dilated Cardiomyopathy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Disease Classification
2.3. Data Collection and Measurement of sST2
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. The Combined Effect of sST2 and β-Blocker on Adverse Events in PDCM
3.3. Subgroup Analysis
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Without β-Blocker | With β-Blocker | p Value | ||
---|---|---|---|---|---|
sST2 < Median | sST2 ≥ Median | sST2 < Median | sST2 ≥ Median | ||
Participants, n (%) | 30 (24.47) | 41 (32.98) | 32 (25.53) | 21 (17.02) | |
Age, months | 17.0 (8.0–48.0) | 33.0 (10.0–117.0) | 23.0 (15.0–64.5) | 52.5 (10.5–107.5) | 0.5886 |
Male, n (%) | 13 (39.1) | 26 (64.5) | 17 (54.2) | 18 (87.5) | 0.0205 * |
Previous history of heart failure, n (%) | 9 (30.4) | 15 (35.5) | 19 (58.3) | 3 (12.5) | 0.0253 * |
LVEF raw | 37.0 (34.0–46.0) | 37.0 (31.0–41.0) | 41.5 (32.0–46.5) | 38.0 (32.5–43.0) | 0.4403 |
LV fraction shortening raw | 17.0 (16.0–23.0) | 18.0 (15.0–20.0) | 19.5 (13.0–23.0) | 19 (15.5–21.0) | 0.8248 |
LVEDD, z score | 4.3 (3.2–5.8) | 4.8 (3.3–5.2) | 4.9 (3.9–6.5) | 3.5 (2.5–5.5) | 0.1605 |
Septal thickness, z score | 1.4 (0.7–2.2) | 1.1 (0.0–1.8) | 0.8 (0.2–1.8) | 0.4 (0.04–1.0) | 0.0550 |
LV posterior wall thickness, z score | 1.0 (0.5–1.9) | 0.8 (0.08–1.4) | 1.1 (0.4–1.8) | 0.5 (0.08–1.0) | 0.3003 |
Laboratory data | |||||
HDL cholesterol, mmol/L | 1.3 (1.1–1.7) | 1.3 (1.1–1.5) | 1.4 (1.1–1.8) | 1.2 (1.1–1.4) | 0.6063 |
LDL cholesterol, mmol/L | 2.6 (1.8–3.6) | 2.3 (1.8–2.8) | 2.5 (2.1–3.2) | 2.2 (1.8–2.9) | 0.8201 |
Total cholesterol, mmol/L | 4.4 (3.5–5.6) | 4.1 (3.4–4.6) | 4.3 (3.7–5.2) | 3.6 (3.6–4.5) | 0.3491 |
Creatinine, μmol/L | 26.5 (21.6–37.5) | 27.6 (20.6–37.1) | 30.0 (23.5–42.8) | 34.9 (22.7–41.1) | 0.6145 |
Urea, μmol/L | 3.3 (3.0–4.3) | 4.6 (3.8–5.3) | 4.5 (3.4–5.9) | 3.9 (3.7–4.8) | 0.0620 |
Glucose, mmol/L | 5.1 (4.6–5.3) | 4.9 (4.6–5.1) | 4.9 (4.5–5.3) | 4.9 (4.5–5.1) | 0.8298 |
BNP, pg/mL | 145.0 (73.0–411.0) | 324.0 (91.0–605.0) | 242.5 (68.5–495.5) | 306.5 (169.5–621.0) | 0.4426 |
C-reactive protein, μmol/L | 0.2 (0.1–0.5) | 0.3 (0.2–0.6) | 0.16 (0.1–1.2) | 0.1 (0.1–1.1) | 0.6137 |
Characteristics | Patients without Adverse Events (n = 87) | Patients with Adverse Events (n = 37) | p Value |
---|---|---|---|
Age, months | 24.0 (12.0–59.0) | 15.0 (10.0–104.0) | 0.5909 |
Male, n (%) | 48 (54.6) | 26 (71.4) | 0.1272 |
Previous history of heart failure, n (%) | 28 (31.8) | 18 (46.4) | 0.1776 |
Echocardiographic measurements at enrollment | |||
LV ejection fraction raw | 41.0 (32.0–46.0) | 35.0 (32.5–38.0) | 0.0045 * |
LV fraction shortening raw | 20.0 (15.0–23.0) | 17.0 (15.5–19.0) | 0.0218 * |
LVEDD, z score | 3.9 (3.1–5.6) | 4.9 (4.4–6.2) | 0.0235 * |
Septal thickness, z score | 1.0 (0.2–1.8) | 0.9 (0.1–1.6) | 0.9934 |
LV posterior wall thickness, z score | 0.8 (0.2–1.8) | 0.7 (0.07–1.3) | 0.4492 |
Laboratory data | |||
HDL cholesterol, mmol/L | 1.3 (1.1–1.6) | 1.2 (0.9–1.5) | 0.1543 |
LDL cholesterol, mmol/L | 2.3 (1.8–3.0) | 2.6 (2.1–3.5) | 0.2287 |
Total cholesterol, mmol/L | 4.1 (3.5–5.2) | 4.2 (3.7–5.9) | 0.2326 |
Creatinine, μmol/L | 27.4 (22.4–39.1) | 35.0 (21.3–40.0) | 0.5302 |
Urea, μmol/L | 4.0 (3.3–5.2) | 4.0 (3.0–5.1) | 0.7391 |
Glucose, mmol/L | 4.9 (4.5–5.3) | 4.9 (4.5–5.2) | 0.9621 |
BNP, pg/mL | 164.0 (69.0–411.0) | 473.5 (285.5–602.0) | 0.0003 * |
C-reactive protein, μmol/L | 0.2 (0.1–0.7) | 0.3 (0.1–1.2) | 0.4163 |
Without β-Blocker | With β-Blocker | |||
---|---|---|---|---|
sST2 < Median | sST2 ≥ Median | sST2 < Median | sST2 ≥ Median | |
Case, n (%) | 3 (8.70) | 16 (38.71) | 15 (46.88) | 4 (20.83) |
Incidence rate (per 1000-person year) | 0.12 (0.03–0.49) | 0.69 (0.39–1.21) | 0.97 (0.50–1.86) | 0.31 (0.13–0.75) |
Unadjusted | ||||
HR (95% CI) | Reference | 5.74 (1.28–25.85) | 7.12 (1.52–33.35) | 2.67 (0.52–13.79) |
p-value | 0.0228 | 0.0128 | 0.2403 | |
Adjusted | ||||
HR (95% CI) | Reference | 5.51 (1.17–25.84) | 7.01 (1.21–40.45) | 2.47 (0.45–13.69) |
p-value | 0.0305 | 0.0296 | 0.3009 |
Variables | Without β-Blocker | With β-Blocker | P for Interaction | ||
---|---|---|---|---|---|
sST2 < Median | sST2 ≥ Median | sST2 < Median | sST2 ≥ Median | ||
Gender | |||||
Female | Reference | 11.51 (0.79–166.84) | 165.63 (2.98–921.25) | 3.13 (0.13–74.63) | 0.5380 |
Male | Reference | 2.82 (0.30–26.34) | 3.99 (0.41–38.85) | 1.87 (0.19–18.70) | |
Previous history of heart failure | |||||
No | Reference | 2.33 (0.22–25.04) | 2.92 (0.26–32.63) | 2.37 (0.21–27.21) | 0.8702 |
Yes | Reference | 6.15 (0.68–55.41) | 8.17 (0.38–177.12) | 1.70 (0.14–20.27) | |
Septal thickness, z score | |||||
<Median | Reference | 3.95 (0.30–52.31) | 5.25 (0.47–58.81) | 1.13 (0.08–16.04) | 0.7741 |
≥Median | Reference | 6.51 (0.61–69.86) | 6.87 (0.42–111.05) | 2.86 (0.24–33.52) | |
Urea, μmol/L | |||||
<Median | Reference | 6.96 (0.67–72.33) | 10.21 (0.80–130.82) | 3.68 (0.30–44.54) | 0.8019 |
≥Median | Reference | 1.58 (0.15–16.38) | 2.09 (0.13–34.15) | 0.36 (0.02–6.20) | |
BNP | |||||
<Median | Reference | 2.18 (0.04–10.56) | 6.17 (0.23–34.57) | 1.64 (0.02–11.01) | 0.8914 |
≥Median | Reference | 5.20 (0.78–34.81) | 5.55 (1.10–28.07) | 2.14 (0.34–13.60) |
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Jiao, M.; Wang, X.; Liang, Y.; Yang, Y.; Gu, Y.; Wang, Z.; Lv, Z.; Jin, M. Effect of β-Blocker Therapy on the Level of Soluble ST2 Protein in Pediatric Dilated Cardiomyopathy. Medicina 2022, 58, 1339. https://doi.org/10.3390/medicina58101339
Jiao M, Wang X, Liang Y, Yang Y, Gu Y, Wang Z, Lv Z, Jin M. Effect of β-Blocker Therapy on the Level of Soluble ST2 Protein in Pediatric Dilated Cardiomyopathy. Medicina. 2022; 58(10):1339. https://doi.org/10.3390/medicina58101339
Chicago/Turabian StyleJiao, Meng, Xiaofang Wang, Yongmei Liang, Yifei Yang, Yan Gu, Zhiyuan Wang, Zhenyu Lv, and Mei Jin. 2022. "Effect of β-Blocker Therapy on the Level of Soluble ST2 Protein in Pediatric Dilated Cardiomyopathy" Medicina 58, no. 10: 1339. https://doi.org/10.3390/medicina58101339