Additional value of Galectin-3 to BNP in acute heart failure patients with preserved ejection fraction
Additional value of Galectin-3 to BNP in acute heart failure patients with preserved ejection fraction
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DOI：
10.1016/j.cca.2016.04.007
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发表时间：
2016-06-01
影响因子：
5
通讯作者：
Palazzuoli, Alberto
中科院分区：
文献类型：
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作者：
Beltrami, Matteo;Ruocco, Gaetano;Palazzuoli, Alberto
背景：几乎一半的急性心力衰竭患者保留了射血分数(HFpEF)。HFpEF是使用传统调查工具的诊断挑战；Galectin-3(Galectin-3)是一种新兴的生物标记物，对心力衰竭的风险个体有用。本研究旨在与射血分数降低(HFrEF)患者比较，分析HFpEF患者Gal-3、BNP与肾功能不全的关系及预后价值。方法：入选98例急性心力衰竭(AHF)患者，于入院12h内检测Gal-3、BNP及估计肾小球滤过率(EGFR)。根据超声心动图的结果，我们将我们的样本分为两组：HFrhf(射血分数50%)或HFpEF(射血分数50%)。结果：两组Gal-3水平差异无统计学意义(HFrEF：19.5+/-5.1 ng/mL；HFpEF：20.5+/-8.7，p=0.56)。GAL-3与肾功能不全呈负相关(LogGal-3与EGFR：r=-0.30，p=0.01)，而与LogBNP水平无相关性(r=0.07，p=055)。GAL-3与高血压性心功能不全患者较晚期的舒张期功能障碍有关(p=0.009)。此外，LogGal-3与舒张期左心室硬度相关(所有患者：r=0.45p<；0.001；高频射血分数：r=0.64p<；0.001)。COX回归分析显示，LogGal-3和LogGal；130与预后不良有关，独立于肾功能不全和其他危险因素(单变量HR23.98[3.03-89.45]；p<；0.001)。校正后的肾功能不全(HR1632[1.98-34.09]；p=0.009)。结论：GAL-3不能区分高位和高位高位静脉曲张。然而，在HFpEF中，它与舒张期功能障碍的严重程度和左室僵硬有关。在HFpEF受试者中，GAL-3显示出独立于肾功能障碍的预后作用。(C)2016爱思唯尔B.V.保留所有权利。
Background: Almost half of patients with acute heart failure have preserved ejection fraction (HFpEF). HFpEF is a diagnostic challenge using traditional investigation tools; Galectin-3 (Gal-3) is an emerging biomarker useful in individuals at risk for HF. The aim of our study is to analyse the relation and prognostic value of Gal-3, BNP and renal dysfunction in patients with HFpEF compared to patients with reduced ejection fraction (HFrEF).Methods: We enrolled 98 patients with acute heart failure (AHF) and measured Gal-3, BNP, and estimated glomerular filtration rate (eGFR) within 12 h of hospital admission. On the basis of echocardiographic findings we divided our sample into two groups: patients with HFrHF (ejection fraction < 50%) or HFpEF (ejection fraction > 50%). Patients were followed up at 6 months.Results: No differences in Gal-3 levels were found in the two subgroups (HFrEF: 19.5 +/- 5.1 ng/mL; HFpEF: 20.5 +/- 8.7, p = 0.56). Gal-3 was inversely related to renal dysfunction (LogGal-3 vs eGFR: r = -0.30, p = 0.01) but did not correlate with LogBNP levels (r = 0.07, p = 055). Gal-3 was associated with more advanced diastolic dysfunction in HFpEF (p = 0.009). In addition LogGal-3 was related to diastolic LV stiffness (all patients: r = 0.45, p < 0.001; HFpEF: r = 0.64, p < 0.001). Cox regression analysis showed that LogGal-3 > 130 was related to poor outcome independently from renal dysfunction and other risk factors only in HFpEF (univariate HR 23.98 [3.03-89.45]; p < 0.001). Adjusted for renal dysfunction (HR 1632 [1.98-34.09]; p = 0.009).Conclusions: Gal-3 is not able to distinguish between HFrEF and HFpEF patients. However it is related to diastolic dysfunction severity and LV stiffness in HFpEF. Gal-3 demonstrates a prognostic role independently from renal dysfunction in subjects with HFpEF. (C) 2016 Elsevier B.V. All rights reserved.