Serum soluble ST2 as a biochemical marker of acute heart failure: future areas of research.

he investigation into biochemical markers is modifying the pproach to the diagnosis and management of heart failure HF). Over the last decade, natriuretic peptides (NPs) have een shown to be particularly useful in confirming or efuting the diagnosis of HF as well as stratifying long-term isk profiles. Several novel cardiac, metabolic, and inflamatory biochemical markers have emerged in the field of F, such as the soluble ST2 receptor (sST2). The receptor ST2 is an interleukin (IL)-1 receptor (IL-1R) amily member that has 2 primary isoforms regulated by ifferent promoters. The transmembrane ST2 isoform (ST2L) s a membrane-bound isoform with 3 extracellular immunolobulin G domains, a single transmembrane domain, and an ntracellular domain homologous to Toll-like receptors and ther IL-1Rs. The sST2 isoform lacks the transmembrane and ntracellular domains. Both ST2L and sST2 are transcriptionlly induced by mechanical strain in rat cardiomyocytes and ardiac fibroblasts (1,2), as well as by IL-1 , and phorbol ester n cardiomyocytes (1).