van der Velde A Rogier, Lexis Chris P H, Meijers Wouter C, van der Horst Iwan C, Lipsic Erik, Dokter Martin M, van Veldhuisen Dirk J, van der Harst Pim, de Boer Rudolf A
University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands.
University of Groningen, Department of Critical Care, University Medical Center Groningen, Groningen, the Netherlands.
Clin Chim Acta. 2016 Jan 15;452:50-7. doi: 10.1016/j.cca.2015.10.034. Epub 2015 Oct 31.
Fibrosis is a pivotal event in infarct repair and progressive remodeling after myocardial infarction (MI). Biomarkers may be used to monitor fibrosis, and therefore we evaluated the predictive value of galectin-3 and sST2 for cardiac remodeling after MI.
Plasma galectin-3 and sST2 were measured in patients admitted with primary percutaneous coronary intervention (PCI) for acute MI, at baseline and at 4months. Left ventricular ejection fraction (LVEF) and infarct size were measured after 4months with cardiac MRI (CMR).
In total, 247 patients had blood samples and CMR data available (mean age 57.7±11.6years; 79.8% male). Increased baseline galectin-3 (≥17.8ng/mL) identified patients with lower LVEF (50.3% (±9.1) vs. non-elevated galectin-3 55.0% (±8.0); P<0.001), and larger infarct size (13.8g. (±12.9) vs. 8.6g. (±8.7); P=0.002) after 4months. Elevated sST2 (≥35.0ng/mL) did not predict decreased LVEF or larger infarct size. Furthermore we showed that at baseline, galectin-3 was an independent predictor for LVEF (β=-0.18; P=0.005) and infarct size (β=0.18; P=0.004). We repeated the analyses using median values of galectin-3 (13.4ng/mL) and sST2 (30.3ng/mL) as a cut point, and this validated our results.
The fibrosis biomarker galectin-3, but not sST2, taken immediately after MI, predicts LVEF and infarct size after 4months. We hypothesize that galectin-3 may play a role in the pathophysiology of cardiac remodeling after acute MI.
纤维化是心肌梗死（MI）后梗死修复和进行性重塑的关键事件。生物标志物可用于监测纤维化，因此我们评估了半乳糖凝集素-3和可溶性ST2（sST2）对MI后心脏重塑的预测价值。
对因急性MI接受直接经皮冠状动脉介入治疗（PCI）的患者在基线和4个月时测定血浆半乳糖凝集素-3和sST2。4个月后用心脏磁共振成像（CMR）测量左心室射血分数（LVEF）和梗死面积。
共有247例患者有血样和CMR数据（平均年龄57.7±11.6岁；79.8%为男性）。基线时半乳糖凝集素-3升高（≥17.8ng/mL）可识别出4个月后LVEF较低的患者（50.3%（±9.1），而半乳糖凝集素-3未升高者为55.0%（±8.0）；P<0.001）以及梗死面积较大的患者（13.8g（±12.9），而未升高者为8.6g（±8.7）；P=0.002）。sST2升高（≥35.0ng/mL）不能预测LVEF降低或梗死面积增大。此外，我们发现基线时半乳糖凝集素-3是LVEF（β=-0.18；P=0.005）和梗死面积（β=0.18；P=0.004）的独立预测因子。我们以半乳糖凝集素-3的中位数（13.4ng/mL）和sST2的中位数（30.3ng/mL）作为切点重复分析，结果得到验证。
MI后立即检测的纤维化生物标志物半乳糖凝集素-3而非sST2可预测4个月后的LVEF和梗死面积。我们推测半乳糖凝集素-3可能在急性MI后心脏重塑的病理生理过程中起作用。
