The level of soluble receptor of 33 sST2 and subclinical myocardial dysfunction in patients with systemic lupus erythematosus

The aim – to determine the level of sST2 in patients with systemic lupus erythematosus (SLE), its relationship with traditional rick factors (TRF) of cardiovascular diseases (CVD), clinical and immunological manifestations of SLE, echocardiography (ECHO) parameters, including global longitudinal strain of left ventricle (GLS LV).

Subjects and methods. The study included 100 patients with a reliable diagnosis of SLE. The average age was 33.2±9.3 years, the median (Me) duration was 1.5 [1.0; 8.7] years. The median SLE activity according to the SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index 2000) was 8 [4; 10] points. The level of sST2 was measured in the blood serum of all patients. All patients underwent ECHO with an assessment of GLS LV using the speckle tracking. The control group consisted of 30 healthy people of comparable age and gender.

Results. In patients with SLE, the sST2 level is higher than in the control (10.03 [6.6; 16.03] and 7.0 [5.3; 10.6] ng/ml (p<0.003)). Patients with SLE were divided into 2 groups: group 1 – sST≥18.8 ng/ml (n=20); group 2 – sST<18.8 ng/ml (n=80). Patients in group 1 were younger, had higher levels of diastolic blood pressure and uric acid, hypertension was more common (25% and 6.3%, respectively), CVD heredity (45% and 20%, respectively), nephritis (50% and 21.3%, respectively) compared with group 2. GLS LV was lower in group 1 (–17.0 [–15.2; –19.5]% and –18.7 [–17.7; –20.7]%, respectively; р=0,016). sST2 corelated with SLEDAI-2K (r=0.325), glucocorticoid dose (r=0.353), anti-DNA level (r=0.328), anti-Sm (r=0.253) (p<0.05 in all cases). According to multifactorial analysis, nephritis, triglyceride level, serositis, low-density lipoprotein level, and heart rate correlate with sST2.

Conclusion. In patients with SLE, the sST2 level is increased in comparison with control. sST2 increase related with TRF, clinical and immunological manifestations of SLE. In patients with SLE and low GLS LV, the sST2 level was higher. In patients with SLE, subclinical myocardial damage develops at an early stage of the disease.

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