Background: Philippine data on utilization of serum Suppression of Tumorigenicity 2 (sST2) and 2-dimensional speckle tracking echocardiography (2D-STE) among patients with acute coronary syndrome (ACS) post- "acute phase" is non-existent. This study aimed to determine the association between LV function utilizing 2-dimensional left ventricular ejection fraction (2D-L VEF), 2D-STE and sST2 then also determine whether changes in global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) measurements during an acute myocardial infarction (AMI) correlates with the level of concentration of sST2.
Methods: This is a prospective cross sectional study of ACS patients admitted at the Philippine Heart Center (PHC) from September 2015 to January 2016 who underwent 2D-LVEF, 2D-STE measurements and sST2 (Presage) sampling within 48-72 hours after successful primary or rescue PCI for ST-segment elevation myocardial infarction (STEMI) and also within 48-72 hours of admission for stable non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA) and STEMI treated medically.
Results: 87 patients were included. There were 70% males and the majority were hypertensive (70%). Half of patients have STEMI yet, less than 20% underwent primary coronary intervention (PCI). The mean 2D-LVEF of the study population was (51.70+48.71 %) by Simpson's method. Baseline 2D-LV EF(r=0.055, p=0.60) was not correlated with sST2. GLS(r=0.14,p=0.17) and GCS(r=0.10,p=0.35) exhibit direct but weak non-significant correlation while GRS (r=-0.14, p=0.18) showed inverse but weak non-significant correlation with sST2 during AMI.
Conclusion: 2D-LVEF did not show correlation while 2D-STE measurements are weakly correlated with sST2 during AMI among Filipinos. This confirms that sST2 may not be purely a marker of hemodynamic stress, fibrosis and adverse myocardial remodeling but may likely reflect to greater degree the state inflammatory response.