[Diagnostic value of combining serum soluble ST2 and interleukin-33 for heart failure patients with preserved left ventricular ejection fraction].

Objective: Diagnostic efficacy of serum markers is low for heart failure patients with preserved left ventricular ejection fraction (HF-pEF) as compared to heart failure patients with reduced left ventricular ejection fraction.We sought to explore the diagnostic value of serum levels of soluble ST2 (sST2) combined with interleukin-33 (IL-33) for the diagnosis of HF-pEF in this study. Methods: A total of 376 patients with HF-pEF (HF group), 376 matched-control patients without heart failure who shared similar clinical characteristics (non-HF group) were included in the study.Another 500 healthy individuals were recruited for assessing the normal ranges of IL-33 and sST2.Serum levels of NT-proBNP were measured by chemi-luminescence assay, while IL-33 and sST2 were measured by enzyme linked immunosorbent assay. Results: Serum levels of IL-33 and sST2 were not normally distributed in healthy population.Serum concentrations of IL-33 and sST2 were significantly higher in HF-pEF patients than in patients in non-HF group (median, IL-33: 0.437 µg/L vs. 0.127 µg/L, P<0.01; sST: 0.118 µg/L vs. 0.067 µg/L, P<0.01). The area under receiver operating characteristic curve (AUC) of sST2 for detecting HF-pEF was 0.763 (95%CI 0.729-0.795, P<0.01), with 71.01% sensitivity and 66.75% specificity, the AUC was 0.884 (95%CI 0.859-0.908, P<0.01), with 80.05% sensitivity and 81.91% specificity in patients with serum IL-33 higher than 0.117 µg/L (median level of serum IL-33 in healthy individuals, n=306). The AUC of NT-proBNP for detecting HF-pEF was 0.83, with 74.73% sensitivity and 84.57% specificity.The AUC of sST2 for detecting HF-pEF was significantly higher than NT-proBNP in population with high serum IL-33 (AUC: 0.88 vs. 0.83, P<0.01). Conclusion: Serum sST2 could serve as a satisfactory biomarker for HF-pEF diagnosis, especially for patients with high serum IL-33 concentrations.

Selective estrogen receptor modulators promising for cardiac syndrome X.

Cardiac syndrome X (CSX) is defined as a typical anginal-like chest pain with a transient ischemic electrocardiogram, but without abnormal coronary angiography. It is usually accepted that endothelial dysfunction, inflammation, oxidative stress and estrogen deficiency are the main reasons of CSX. There are some methods to treat CSX including statins, b blocker, angiotensin converting enzyme inhibitors, nitrates, estrogen, and so on. The estrogen replacement therapy (ERT), in particular, has been reported by many researchers to significantly reduce the frequency of chest pain after administration of estrogen, which has been explained as estrogen acting on its receptor to improve the endothelial function. However, it has been suggested that ERT must not be used for coronary heart disease due to its adverse effects. However, some selective estrogen receptor modulators (SERMs) can inhibit inflammatory response as well as oxidative stress, and improve the endothelial function, to reduce the occurrence of chest pain. Here, we hypothesize that SERMs may be the beneficial selection for patients with CSX.

Effects of endothelin receptor A antagonist FR139317 on rats with congestive heart failure.

AIM: To study the effects of a selective endothelin receptor A (ETA) antagonist FR139317 on rats with congestive heart failure. METHODS: A congestive heart failure model was established via left coronary artery ligation in adult male Wistar rats. The rats with congestive heart failure were treated with FR139317 at two doses (1 and 5 mg . kg-1 . d-1 respectively for 6 weeks) or with vehicle. Hemodynamics, plasma level of endothelin-1 (ET-1), and mortality rate of rats were measured. RESULTS: Both groups treated with FR139317 (high and low dose) have lower mortality rate (25.0 % and 28.6 % vs 50.0 %) and lower plasma level of ET-1 than that of vehicle [(3.6 +/- 1.2) ng/L and (4.9 +/- 1.5) ng/L vs (5.8 +/- 1.3) ng/L]. Comparing to vehicle group, left ventricular end-diastolic pressures of the FR139317-treated groups were improved significantly [(12 +/- 6) mmHg and (14 +/- 7) mmHg vs (22 +/- 9) mmHg]. FR139317 at a higher dose reduced the mean arterial pressure of the rats with congestive heart failure and decreased the plasma concentration of endothelin to a closer level of rats with normal heart function than lower dose. CONCLUSION: Selective ETA antagonist FR139317 improved the hemodynamics and reduced the plasma ET-1 level and the mortality of rats with congestive heart failure