Association of soluble ST2 with functional capacity in outpatients with heart failure.

BACKGROUND: Biomarkers play an important role in the risk stratification of patients with heart failure (HF). Recent studies have shown that soluble suppression of tumorigenicity 2 (sST2), a member of the interleukin 1 receptor family, is associated with disease prognosis in acute and chronic HF. In this study we aimed to investigate the relation between sST2 level and functional capacity in outpatients with systolic HF. PATIENTS AND METHODS: This study included 120 HF patients with reduced ejection fraction (HFrEF; EF ≤ 40%). The mean age of patients was 66 ± 11 years. Advanced HF (New York Heart Association [NYHA] functional class III-IV) was observed in 35 patients (29%). RESULTS: sST2 levels were on average higher in patients with NYHA functional classes III and IV than in patients with NYHA functional classes I and II (51 [9-198] vs. 25 ng/ml [9-118], p < 0.001). In a multiple logistic regression model, sST2 level (OR: 1.044, p = 0.004, 95% CI: 1.014-1.075), hemoglobin level (OR: 0.590, p = 0.001, 95% CI: 0.433-0.805), total cholesterol level (OR: 0.977, p = 0.004, 95% CI: 0.962-0.993), and age (OR: 1.066, p = 0.047, 95% CI: 1.001-1.136) were associated with poor functional capacity. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of sST2 for predicting poor functional capacity was >42 ng/ml, with 63% sensitivity and 88% specificity (AUC: 0.810, 95% CI: 0.728- 0.875). CONCLUSION: Higher sST2 levels were strongly associated with poor NYHA functional class, independent of cardiac risk factors, in outpatients with HFrEF.

Indoor/outdoor concentrations and elemental composition of PM10/PM2.5 in urban/industrial areas of Kocaeli City, Turkey.

This study presents indoor/outdoor PM2.5 and PM10 concentrations measured during winter and summer in 15 homes in Kocaeli, which is one of the most industrialized areas in Turkey. Indoor and outdoor PM2.5 and PM10 mass concentrations and elemental composition were determined using an X-ray fluorescence spectrometer. Quantitative information was obtained on mass concentrations and other characteristics such as seasonal variation, indoor/outdoor (I/O) ratio, PM2.5/PM10 ratio, correlations and sources. Average indoor and outdoor PM2.5 concentrations were 29.8 and 23.5 microg/m(3) for the summer period, and 24.4 and 21.8 microg/m(3) for the winter period, respectively. Average indoor and outdoor PM10 concentrations were 45.5 and 59.9 microg/m(3) for the summer period, and 56.9 and 102.3 microg/m(3) for the winter period, respectively. A varimax rotated factor analysis (FA) was performed separately on indoor and outdoor datasets in an effort to identify possible heavy metal sources of PM2.5 and PM10 particle fractions. FA of outdoor data produced source categories comprising polluted soil, industry, motor vehicles, and fossil fuel combustion for both PM fractions, while source categories determined for indoor data for both PM2.5 and PM10 comprised industry, polluted soil, motor vehicles, and smoking, with an additional source category of cooking activities detected for the PM2.5 fraction. Practical Implications In buildings close to industrial areas or traffic arteries, outdoor sources may have an important effect on indoor air pollution. Therefore, indoor and outdoor investigations should be conducted simultaneously to assess the relationship between indoor and outdoor pollution. This study presents the simultaneous measurement of PM fractions (PM2.5 and PM10) and their elemental compositions to determine the sources of respirable PM and the heavy metals bound to these particles in indoor air. Factor analysis of indoor data indicated that the contribution of outdoor pollutant sources to indoor pollution was about 70%, making these sources the most significant for indoor heavy metal pollution, wheras other sources of indoor pollution included smoking and cooking activities.