الفهرس 
Serial Speckle Tracking Echocardiography and Serum sST2 Levels Adds Information in Acute Decompensated Heart Failure Patients
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Abstract
Background:sST2 (suppression of tumorigenicity 2) isa marker of myocardial fibrosis and remodelling, that has been successfully added to conventional tools in the management of patients with acute decompensatedheart failure (ADHF).Although baseline sST2 values at ADHF admission have been proved to predict outcomes, serial measurements are even of greater value.Speckle-tracking echocardiography imaging is a non-invasive ultrasound technique that allows an objective and quantitative evaluation of changes in cardiac functions in ADHF patients.Objectives: To evaluate the dynamic cardiac structural and functional changes in patients with AHF together with changes in serum sST2 levels during hospitalization. Methods: We prospectively enrolled 61 ADHF patients with left ventricular ejection fraction less than 50%. Blood samples were collected to measure serum sST2 levelson admission and hospital discharge.All patients underwent serial conventional and speckle tracking echocardiography on admission, after the first 48 hours and on hospital discharge. Results: Our study showed significant reduction in serum sST2 levels from admission to hospital discharge (P <0.0001) which was accompanied with significant improvement in left ventricle global longitudinal strain(LV GLS) (P= 0.001), left atrium reservoir strain(LASr) (P= 0.02), left atrium contraction strain(LASct) (P= 0.001) and left atrium stiffness index (LASI) (P <0.0001) in patients with more than 25% reduction in serum sST2 levels. The change in serum sST2 levels between admission and hospital discharge was strongly correlated with changes in LASI(r= 0.71, P <0.0001) and LASr(r= -0.66, P <0.0001)