Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients

Abstract Aim Soluble suppression of tumorigenicity‐2 (sST2) is a strong prognostic biomarker in heart failure. The emerging understanding of circadian biology in cardiovascular disease may lead to novel applications in prognosis and diagnosis and may provide insight into mechanistic aspects of the d...

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Main Authors: Sandra Crnko, Markella I. Printezi, Tijn P.J. Jansen, Laurynas Leiteris, Manon G. van derMeer, Hilde Schutte, Martijn vanFaassen, Bastiaan C. duPré, Nicolaas deJonge, Folkert W. Asselbergs, Carlo A.J.M. Gaillard, Hans Kemperman, Pieter A. Doevendans, Joost P.G. Sluijter, Linda W. vanLaake
Format: Article
Language:English
Published: Wiley 2020-06-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.12673
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author Sandra Crnko
Markella I. Printezi
Tijn P.J. Jansen
Laurynas Leiteris
Manon G. van derMeer
Hilde Schutte
Martijn vanFaassen
Bastiaan C. duPré
Nicolaas deJonge
Folkert W. Asselbergs
Carlo A.J.M. Gaillard
Hans Kemperman
Pieter A. Doevendans
Joost P.G. Sluijter
Linda W. vanLaake
author_facet Sandra Crnko
Markella I. Printezi
Tijn P.J. Jansen
Laurynas Leiteris
Manon G. van derMeer
Hilde Schutte
Martijn vanFaassen
Bastiaan C. duPré
Nicolaas deJonge
Folkert W. Asselbergs
Carlo A.J.M. Gaillard
Hans Kemperman
Pieter A. Doevendans
Joost P.G. Sluijter
Linda W. vanLaake
author_sort Sandra Crnko
collection DOAJ
description Abstract Aim Soluble suppression of tumorigenicity‐2 (sST2) is a strong prognostic biomarker in heart failure. The emerging understanding of circadian biology in cardiovascular disease may lead to novel applications in prognosis and diagnosis and may provide insight into mechanistic aspects of the disease–biomarker interaction. So far, it is unknown whether sST2 exhibits a diurnal rhythm. Repeated measurements of sST2 may aid in clinical decision making. The goal of this study was to investigate whether sST2 exhibits diurnal variation in patients with heart failure with reduced ejection fraction (HFrEF) and in control subjects, thereby enhancing its diagnostic and prognostic values. Methods and results The study comprised 32 subjects: 16 HFrEF patients and 16 controls. Blood was collected at seven subsequent time points during a 24 h time period. sST2, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), melatonin, and cortisol were measured from serum. Peak values of sST2 clustered at daytime (modal value: 5 p.m.) in 87.6% of all subjects (81.3% of patients, P = 0.021; 93.8% of controls, P = 0.001), and minimum concentrations at night‐time (modal value: 5 a.m.) in 84.4% (87.5% of patients, P = 0.004 81.3% of controls, P = 0.021). A cosinor analysis of mean normalized sST2 values revealed significant cosine shaped 24 h oscillations of patients (P = 0.026) and controls (P = 0.037). NT‐proBNP in contrast did not show a diurnal rhythm, while melatonin and cortisol patterns were intact in all subjects. Conclusions sST2 exhibits a diurnal rhythm with lower values in the morning than in the late afternoon. This new insight could lead to refinement of its diagnostic and prognostic values through specified and consistent sampling times with repeated measurements. For example, by measuring sST2 during the afternoon, when levels are at their highest, false negatives on prognosis prediction could be avoided.
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spelling doaj-art-e41b91a2d1e04fdcb188245108b365232025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-01731224123310.1002/ehf2.12673Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patientsSandra Crnko0Markella I. Printezi1Tijn P.J. Jansen2Laurynas Leiteris3Manon G. van derMeer4Hilde Schutte5Martijn vanFaassen6Bastiaan C. duPré7Nicolaas deJonge8Folkert W. Asselbergs9Carlo A.J.M. Gaillard10Hans Kemperman11Pieter A. Doevendans12Joost P.G. Sluijter13Linda W. vanLaake14Department of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsRegenerative Medicine Centre University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Laboratory Medicine University Medical Centre Groningen, University of Groningen Groningen The NetherlandsDivision of Internal Medicine Erasmus Medical Centre Rotterdam The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDivision of Internal Medicine and Dermatology University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Clinical Chemistry and Haematology University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsDepartment of Cardiology, Experimental Cardiology Laboratory University Medical Centre Utrecht Utrecht The NetherlandsAbstract Aim Soluble suppression of tumorigenicity‐2 (sST2) is a strong prognostic biomarker in heart failure. The emerging understanding of circadian biology in cardiovascular disease may lead to novel applications in prognosis and diagnosis and may provide insight into mechanistic aspects of the disease–biomarker interaction. So far, it is unknown whether sST2 exhibits a diurnal rhythm. Repeated measurements of sST2 may aid in clinical decision making. The goal of this study was to investigate whether sST2 exhibits diurnal variation in patients with heart failure with reduced ejection fraction (HFrEF) and in control subjects, thereby enhancing its diagnostic and prognostic values. Methods and results The study comprised 32 subjects: 16 HFrEF patients and 16 controls. Blood was collected at seven subsequent time points during a 24 h time period. sST2, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), melatonin, and cortisol were measured from serum. Peak values of sST2 clustered at daytime (modal value: 5 p.m.) in 87.6% of all subjects (81.3% of patients, P = 0.021; 93.8% of controls, P = 0.001), and minimum concentrations at night‐time (modal value: 5 a.m.) in 84.4% (87.5% of patients, P = 0.004 81.3% of controls, P = 0.021). A cosinor analysis of mean normalized sST2 values revealed significant cosine shaped 24 h oscillations of patients (P = 0.026) and controls (P = 0.037). NT‐proBNP in contrast did not show a diurnal rhythm, while melatonin and cortisol patterns were intact in all subjects. Conclusions sST2 exhibits a diurnal rhythm with lower values in the morning than in the late afternoon. This new insight could lead to refinement of its diagnostic and prognostic values through specified and consistent sampling times with repeated measurements. For example, by measuring sST2 during the afternoon, when levels are at their highest, false negatives on prognosis prediction could be avoided.https://doi.org/10.1002/ehf2.12673Circadian rhythmDiurnal rhythmHeart failureBiomarkersST2NT‐proBNP
spellingShingle Sandra Crnko
Markella I. Printezi
Tijn P.J. Jansen
Laurynas Leiteris
Manon G. van derMeer
Hilde Schutte
Martijn vanFaassen
Bastiaan C. duPré
Nicolaas deJonge
Folkert W. Asselbergs
Carlo A.J.M. Gaillard
Hans Kemperman
Pieter A. Doevendans
Joost P.G. Sluijter
Linda W. vanLaake
Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
ESC Heart Failure
Circadian rhythm
Diurnal rhythm
Heart failure
Biomarker
sST2
NT‐proBNP
title Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
title_full Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
title_fullStr Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
title_full_unstemmed Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
title_short Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients
title_sort prognostic biomarker soluble st2 exhibits diurnal variation in chronic heart failure patients
topic Circadian rhythm
Diurnal rhythm
Heart failure
Biomarker
sST2
NT‐proBNP
url https://doi.org/10.1002/ehf2.12673
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