肌原纤维化在特发性炎症性肌病（IIM）心脏受累的早期亚临床阶段中发生。已知可溶性肿瘤抑制因子2（sST2）会在自身免疫疾病发展过程中具有免疫调节作用。本研究调查了sST2在IIM心脏受累早期阶段的心肌纤维化诊断价值。共招募了44名正常心脏功能的IIM患者和32名年龄和性别匹配的健康对照组（HC）。采用ELISA测量血清sST2水平，并分析心脏磁共振（CMR）参数（原生T1、ECV、LGE）和水肿（T2值）的心肌纤维化。与HC相比，IIM患者sST2水平显著升高（67.5 ± 30.4与14.4 ± 5.5，ng/ml，P < 0.001），级别与弥漫性心肌纤维化参数原生T1（r = 0.531，P = 0.000）、ECV（r = 0.371，P = 0.013）以及局灶性心肌纤维化指数LGE（r = 0.339，P = 0.024）呈正相关。在年龄、性别、BMI和ESR调整后，sST2是弥漫性和局灶性心肌纤维化的独立预测因子。每单位sST2升高，弥漫性心肌纤维化风险增加约15.4%（Odds ratio，OR 1.154，95%CI 1.021-1.305，P = 0.022），局灶性心肌纤维化风险增加约3.8%（OR 1.038，95%CI 1.006-1.072，P = 0.020）。诊断弥漫性和局灶性心肌纤维化的截断值分别为sST2 ≥ 51.3 ng/ml（AUC = 0.942，灵敏度 = 85.7%，特异性 = 98.9%，P < 0.001）和53.3 ng/ml（AUC = 0.753，灵敏度 = 87.5%，特异性 = 58.3%，P < 0.01）。sST2在IIM心脏受累亚临床阶段表现出明显升高，并具有作为IIM弥漫性和局灶性心肌纤维化的生物标志物的潜力。©The Authors 2023。由牛津大学出版社代表英国风湿病学会出版。保留所有权利。请发送电子邮件到journals.permissions@oup.com以获得授权。

Myocardial fibrosis occurs in the early subclinical stage of cardiac involvement in idiopathic inflammatory myopathies (IIM). Soluble suppression of tumorigenicity 2 (sST2) is known to have an immunomodulatory impact during autoimmune disease development. The current study investigated the diagnostic value of sST2 for myocardial fibrosis during early stage of cardiac involvement in IIM.A total of 44 IIM patients with normal heart function and 32 age- and gender-matched healthy controls (HCs) were enrolled. Serum sST2 levels were measured by ELISA and cardiac magnetic resonance (CMR) parameters for myocardial fibrosis (native T1, ECV, LGE) and oedema (T2 values) were analyzed.IIM patients had significantly higher sST2 levels than HC (67.5 ± 30.4 vs 14.4 ± 5.5, ng/ml, P < 0.001) and levels correlated positively with diffuse myocardial fibrosis parameters, native T1 (r = 0.531, P = 0.000), ECV (r = 0.371, P = 0.013), and focal myocardial fibrosis index, LGE (r = 0.339, P = 0.024) by Spearman's correlation analysis. sST2 was an independent predictive factor for diffuse and focal myocardial fibrosis after adjustment for age, gender, BMI and ESR. Risk increased ∼15.4% for diffuse (Odds ratio, OR 1.154, 95%CI 1.021-1.305, P = 0.022) and 3.8% for focal (OR 1.038, 95%CI 1.006-1.072, P = 0.020) myocardial fibrosis per unit increase of sST2. Cutoff values for diagnosing diffuse and focal myocardial fibrosis were sST2 ≥ 51.3 ng/ml (AUC = 0.942, sensitivity = 85.7%, specificity = 98.9%, P < 0.001) and 53.3 ng/ml (AUC = 0.753, sensitivity = 87.5%, specificity = 58.3%, P < 0.01) respectively.sST2 showed a marked elevation during the subclinical stage of cardiac involvement in IIM and has potential as a biomarker for predicting diffuse and focal myocardial fibrosis in IIM.© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.