Galectin-3 is an independent marker for ventricular remodeling and mortality in patients with chronic heart failure
Galectin-3 is an independent marker for ventricular remodeling and mortality in patients with chronic heart failure
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DOI：
10.1007/s00392-012-0500-y
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发表时间：
2013-02-01
影响因子：
5
通讯作者：
van der Meer, Peter
中科院分区：
文献类型：
--
作者：
Lok, Dirk J.;Lok, Sjoukje I.;van der Meer, Peter
半乳糖凝集素-3（Gal-3）是最近发现的心肌纤维化的标志物，其水平升高与心力衰竭（HF）患者短期随访后的不良结局相关。然而，Gal-3是否与心脏重塑和长期随访后的结果有关尚不清楚。因此，我们确定Gal-3作为一种新的生物标志物在严重慢性HF患者左心室重构和长期预后中的应用。共有240例纽约心脏协会（NYHA）III级和IV级HF患者纳入研究。患者随访8.7 +/-A1年，平均年龄为71 +/-A0.6岁，73%的研究人群为男性。测量NT-proBNP和Gal-3的循环水平。在基线和3个月时进行连续超声心动图检查。基线时，左心室舒张末期容积（LVEDV）中位数为267 mL [四分位距232-322]。根据LVEDV的变化将患者分为三组。与LVEDV稳定或升高的患者相比，LVEDV随时间降低的患者在入组时的Gal-3水平显著较低（14.7 vs. 17.9 vs. 19.0 ng/mL;趋势p = 0.004），而NT-proBNP水平无显著差异（p = 0.33）。多变量线性回归分析显示，半乳糖苷-3水平与LVEDV的变化呈正相关（p = 0.007）。此外，Gal-3是长期随访后死亡率的重要预测因子（p = 0.001）。Gal-3与通过系列超声心动图确定的左心室重构相关，并预测重度慢性HF患者的长期死亡率。
Galectin-3 (Gal-3) is a recently discovered marker for myocardial fibrosis and elevated levels are associated with an impaired outcome after short-term follow-up in heart failure (HF) patients. However, whether Gal-3 is related to cardiac remodeling and outcome after long-term follow-up is unknown. Therefore, we determined the utility of Gal-3 as a novel biomarker for left ventricular remodeling and long-term outcome in patients with severe chronic HF.A total of 240 HF patients with New York Heart Association (NYHA) Class III and IV were included. Patients were followed for 8.7 +/- A 1 years, had a mean age of 71 +/- A 0.6 years and 73 % of the study population was male. Circulating levels of NT-proBNP and Gal-3 were measured. Serial echocardiography was performed at baseline and at 3 months. At baseline median left ventricular end-diastolic volume (LVEDV) was 267 mL [interquartile range 232-322]. Patients were divided into three groups according to the change in LVEDV. Patients in whom the LVEDV decreased over time had significant lower levels of Gal-3 at entry compared to patients in whom the LVEDV was stable or increased (14.7 vs. 17.9 vs. 19.0 ng/mL; p = 0.004 for trend), whereas no significant differences were seen in levels of NT-proBNP (p = 0.33). Multivariate linear regression analyses revealed that Gal-3 levels were positively correlated to change in LVEDV (p = 0.007). In addition, Gal-3 was a significant predictor of mortality after long-term follow-up (p = 0.001).Gal-3 is associated with left ventricular remodeling determined by serial echocardiography and predicts long-term mortality in patients with severe chronic HF.