TY - JOUR ID - TI - Association between Dual-Chamber (DDD) Pacemakers and Plasma Level of Soluble Suppression of Tumorigenicity-2 (Sst2). A Case-Control Study in A Sample of Iraqi Patients AU - Ahmed Hussein Al-Mayali AU - Haider Jabbar Al-Ghizzi AU - Zahraa Abdulali Al-Mudhafar AU - Mudhaffar Sami Khaza`al PY - 2021 VL - 14 IS - 1 SP - 2404 EP - 2411 JO - Karbala Journal of Medicine مجلة كربلاء الطبية SN - 19905483 29580889 AB - Background: Although dual-chamber pacemakers are more physiological, they can negatively impact cardiac function due to the dyssynchrony caused by right ventricular pacing, affecting left ventricular function. Soluble suppression of tumorigenicity-2 (sST2) is an isoform for the ST2, and the second isoform is called transmembrane ST2 (ST2L). After a cardiac insult, IL-33 interacts with ST2L to counteract the adverse effects of that insult. sST2 acts as a decoy receptor for IL-33 competing with ST2L preventing it from binding to IL-33, limiting cardioprotective measures of ST2L/IL33.Objective: This study aimed to investigate the effect of a dual-chamber pacemaker on sST2 levels in patients with preserved ejection fraction.Methods: a case-control study with 52 dual-chamber pacemakers patients, 68% were males, together with 52 controls. Participants were divided into patients and control groups. Exclusion criteria were heart failure, recent acute coronary syndrome, uncontrolled hypertension, left ventricular hypertrophy, uncontrolled diabetes, pulmonary hypertension, right bundle branch block, and atrial fibrillation. sST2 was measured alongside ECG and echo to calculate the EF%, CO, SV, LVPEP, and RVPEP.Results: sST2 was higher in patients (p = 0.0001), 95% CI [18.06, 25.22]. Patients had lower values of EF%, CO, and HR (p = 0.0001). The ΔVPEP was higher in patients (p = 0.0001), 95% CI [18.06, 25.22]. Both, SV and RVPEP showed no significant differences. Conclusion: dual-chamber pacemakers cause elevated sST2 levels due to electromechanical dyssynchrony and minor fibrosis

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