心力衰竭患者血浆半乳糖凝集素-3 水平对预测肾功能不全及生存的价值。
Usefulness of plasma galectin-3 levels in systolic heart failure to predict renal insufficiency and survival.
机构信息
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio, USA.
出版信息
Am J Cardiol. 2011 Aug 1;108(3):385-90. doi: 10.1016/j.amjcard.2011.03.056. Epub 2011 May 19.
Galectin-3 plays an important role in fibroblast activation and fibrosis in animal models. Increased galectin-3 levels are associated with poor long-term survival in heart failure (HF). We examined the relation between plasma galectin-3 levels and myocardial indexes of systolic HF. We measured plasma galectin-3 in 133 subjects with chronic HF and 45 with advanced decompensated HF using echocardiographic and hemodynamic evaluations. In the chronic HF cohort, median plasma galectin-3 level was 13.9 ng/ml (interquartile range 12.1 to 16.9). Higher galectin-3 was associated with more advanced age (r = 0.22, p = 0.010), poor renal function (estimated glomerular filtration rate, r = -0.24, p = 0.007; cystatin C, r = 0.38, p <0.0001) and predicted all-cause mortality (hazard ratio 1.86, 95% confidence interval 1.36 to 2.54, p <0.001). In multivariate analysis, galectin-3 remained an independent predictor of all-cause mortality after adjusting for age, estimated glomerular filtration rate, left ventricular (LV) ejection fraction, and mitral early diastolic myocardial relaxation velocity at septal mitral annulus (hazard ratio 1.94, 95% confidence interval 1.30 to 2.91, p = 0.001). However, galectin-3 did not predict the combined end point of all-cause mortality, cardiac transplantation, or HF hospitalization (p >0.05). Furthermore, there were no relations between galectin-3 and LV end-diastolic volume index (r = -0.05, p = 0.61), LV ejection fraction (r = 0.10, p = 0.25), or LV diastolic function (mitral early diastolic myocardial relaxation velocity at septal mitral annulus, r = 0.06, p = 0.52; left atrial volume index, r = 0.08, p = 0.41). In the advanced decompensated HF cohort, we did not observe any relation between galectin-3 and echocardiographic or hemodynamic indexes. In conclusion, high plasma galectin-3 levels were associated with renal insufficiency and poorer survival in patients with chronic systolic HF. However, we did not observe a relation between galectin-3 and echocardiographic or hemodynamic indexes.
半乳糖凝集素-3 在动物模型中的成纤维细胞激活和纤维化中起着重要作用。半乳糖凝集素-3 水平升高与心力衰竭（HF）的长期预后不良相关。我们研究了血浆半乳糖凝集素-3 水平与收缩性 HF 的心肌指数之间的关系。我们使用超声心动图和血流动力学评估，测量了 133 例慢性 HF 患者和 45 例晚期失代偿 HF 患者的血浆半乳糖凝集素-3 水平。在慢性 HF 队列中，中位血浆半乳糖凝集素-3 水平为 13.9ng/ml（四分位间距 12.1 至 16.9）。较高的半乳糖凝集素-3 与年龄较大（r = 0.22，p = 0.010）、肾功能较差（估计肾小球滤过率，r = -0.24，p = 0.007；胱抑素 C，r = 0.38，p <0.0001）和全因死亡率预测相关（风险比 1.86，95%置信区间 1.36 至 2.54，p <0.001）。在多变量分析中，在校正年龄、估计肾小球滤过率、左心室（LV）射血分数和二尖瓣环间隔的早期舒张心肌松弛速度后，半乳糖凝集素-3 仍然是全因死亡率的独立预测因素（风险比 1.94，95%置信区间 1.30 至 2.91，p = 0.001）。然而，半乳糖凝集素-3 不能预测全因死亡率、心脏移植或 HF 住院的联合终点（p >0.05）。此外，半乳糖凝集素-3 与 LV 舒张末期容积指数（r = -0.05，p = 0.61）、LV 射血分数（r = 0.10，p = 0.25）或 LV 舒张功能（二尖瓣环间隔的早期舒张心肌松弛速度，r = 0.06，p = 0.52；左心房容积指数，r = 0.08，p = 0.41）之间均无相关性。在晚期失代偿 HF 队列中，我们未观察到半乳糖凝集素-3 与超声心动图或血流动力学指标之间存在任何关系。总之，高血浆半乳糖凝集素-3 水平与慢性收缩性 HF 患者的肾功能不全和生存率降低相关。然而，我们没有观察到半乳糖凝集素-3 与超声心动图或血流动力学指标之间存在任何关系。
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