ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: A cardiac magnetic resonance study.

Background: The association of soluble interleukin-1 receptor-like 1 (ST2) with left ventricular (LV) remodeling is unclear in patients with a first ST-segment elevation myocardial infarction (STEMI). The objective of this work was to assess the relationship between ST2, a marker of inflammation, and cardiac magnetic resonance (CMR) imaging-derived LV remodeling after a first STEMI.

Methods: We prospectively evaluated 109 patients with a first STEMI treated with primary percutaneous coronary intervention who had ST2 assessed 24 h post-reperfusion. All patients underwent CMR imaging 1 week and 6 months after STEMI. The independent associations between ST2, LV diastolic and systolic volume indices, and LV ejection fraction (LVEF) were evaluated by linear mixed models.

Results: The mean age of the sample was 59 ± 12 years, 85 patients (78%) were male, and 13 (11.9%) had a LVEF ≤40%. The median (IQR) of ST2 was 55.3 (38.7-94.1) pg/mL. At 1-week CMR higher ST2 was related to more infarct size and less myocardial salvage index (p < 0.01). Overall, after comprehensive multivariable adjustment, higher baseline ST2 was associated with progressive LV volume indices dilation and LVEF deterioration (p < 0.05). This effect was stronger in patients with severe 1-week structural damage, namely those with large infarct size, extensive microvascular obstruction or LVEF ≤40%.

Conclusions: In patients with a first STEMI treated with primary percutaneous coronary intervention, soluble ST2 predicts dynamic changes in CMR-derived LV volumes and LVEF. Future studies must assess whether targeting interleukin-1 leads to lower ST2 levels and less LV remodeling.