Prognostic Value of ST2 Biomarkers in Hypertonic Disease Patients on the Background of the Chronic Obstructive Pulmonary Disease

Scientific research conducted by domestic and foreign scientists and many years of clinical experience proves that patients usually have chronic obstructive pulmonary disease in combination with arterial hypertension. Soluble form of ST2 protein in these patients is involved in certain inflammatory diseases and serves a marker, which determines the prognosis in patients with heart and lung deficiency and predicts the patient's death during the year. The purpose of this study was to evaluate the expression of ST2 protein in patients with arterial hypertension on the background of chronic obstructive pulmonary disease. Material and methods. 23 patients were diagnosed with arterial hypertension stage II and chronic obstructive pulmonary disease stage II without clinically significant concomitant disease, with an average age of 51.72 ± 1.22 years (49.33-54.09) (gender composition: 22 males and 1 female), the smoking status was comparable to chronic obstructive pulmonary disease patients, 18 patients with arterial hypertension of both sexes aged from 33 to 67 (mean age 50.74 ± 1.49 years (47.81-53.76), male / female ratio 17 / 83%), stage II of the arterial hypertension with the level of I-III degree of hypertension, different cardiovascular risk, without adequate systematic antihypertensive therapy and 18 patients with chronic obstructive pulmonary disease stage II, mean age 50.32 ± 0.99 (48.22-52.16) (gender composition: 14 males and 4 females), duration of the disease was 7.52 ± 1.14 years. 80% of active smokers, the index of bacon-years was 17.23 ± 2.69 years, the harmful professional factors (industrial) indicated 23.53%. Participants expressed their willingness to be included in medical research. Results and discussion. The obtained data indicate that the lowest level of ST2 protein expression was detected in patients with hypertension without concomitant pathology – 21.05 ± 2.12 ng/mL, which is by 11.78% lower than in patients with chronic obstructive pulmonary disease without concomitant pathology (23,53 ± 1.8 ng/mL). The highest ST2 protein expression was demonstrated in patients with comorbid pathology group with chronic obstructive pulmonary disease on the background of arterial hypertension – 33.01 ± 6.25 ng/mL, which is by 56.82% higher compared with patients with arterial hypertension, and by 40.29% higher than analogous marker in patients with monopathology in the form of chronic obstructive pulmonary disease. In the group of chronic obstructive pulmonary disease patients with a high level of ST2 (more than 30 ng / ml), significantly more negatively controlled negative cardiovascular predictors, such as the presence of left ventricular hypertrophy (χ2 = 7.61 at p = 0.006) and sympathetic balance disturbances according to the LF / HF index (χ2 = 4.72 at p = 0.03) and ST2 elevation was reliably associated not only with extrapulmonary prognostic factors, but also with a decrease in FEV1 of less than 50% (χ2 = 5.45 at p = 0.02). Conclusion. Patients of the experimental group with comorbid pathology arterial hypertension and chronic obstructive pulmonary disease had the most significant increasing level of ST2 protein as unfavorable prognosis marker compared to the groups of patients without combination of this pathology.