Soluble ST2 and CXCL-10 may Serve as Biomarkers of Diastolic Dysfunction in SLE and Correlate with Disease Activity and Damage

Background: Subclinical myocardial dysfunction has been reported to occur early in systemic lupus erythematous (SLE).

Aim: To search for biomarkers of subclinical myocardial dysfunction which may correlate with disease activity in SLE patients.

Methods: This is a prospective, controlled, cross-sectional study of 57 consecutive patients with SLE and 18 controls. Serum samples were obtained to determine serum soluble ST2 (sST2), CXCL-10 and high-sensitivity troponin (hs-troponin) levels. All participants underwent an echocardiographic tissue Doppler study.

Results: sST2, CXCL-10 and hs-troponin levels were higher in patients with higher SLE disease activity (SLEDAI). And sST2 and CXCL-10 were higher in patients with more disease damage as measured by the SLE damage index. Measures of diastolic dysfunction, as assessed by echocardiographic tissue doppler negatively correlated with log CXCL-10: including E/A; E/e`<sub>lateral</sub> and E/e`_septal, while E/e’ positively correlated with CXCL-10. Diastolic dysfunction parameters also correlated with log sST2 levels, a negative correlation was seen with E/e`_lateral and a positive correlation was seen with E/e’. Systolic dysfunction parameters positively correlated with hs-troponin: LVED, LVES. In a multivariate analysis, log sST2 and log CXCL-10 were significantly different in SLE patients as compared to controls, independent of cardiovascular risk factors. In a multivariate analysis, sST2 and CXCL-10 were found to be significantly different in SLE vs. healthy controls, independent of each other.

Conclusions: Soluble ST2 and CXCL-10 are markers of disease activity and accrued damage in SLE and may serve as sensitive biomarkers for early detection of diastolic dysfunction, independent of traditional cardiovascular risk factors.