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慢性阻塞性肺疾病合并肺动脉高压患者右心室功能障碍的超声心动图参数与半乳糖凝集素-3之间的相关性

Correlations between echocardiographic parameters of right ventricular dysfunction and Galectin-3 in patients with chronic obstructive pulmonary disease and pulmonary hypertension.

作者信息

Agoston-Coldea Lucia, Lupu Silvia, Petrovai Dana, Mocan Teodora, Mousseaux Elie

机构信息

2nd Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

University of Medicine and Pharmacy, Targu Mures, Romania.

出版信息

Med Ultrason. 2015 Dec;17(4):487-95. doi: 10.11152/mu.2013.2066.174.ech.

Abstract

AIM

To evaluate the association between echocardiographic right ventricular (RV) structural and functional parameters and galectin-3 levels in patients with chronic obstructive pulmonary disease (COPD) and associated pulmonary hypertension presenting with acutely aggravated dyspnoea.

MATERIAL AND METHODS

We conducted a prospective study on forty patients with COPD and forty healthy volunteers matched for age and sex (mean age 59+/-6 years), measuring galectin-3 and NT-proBNP serum levels and specific echocardiographic parameters.

RESULTS

Galectin-3 was significantly higher in patients with COPD and elevated systolic pulmonary artery pressure than in healthy volunteers and discriminated better between patients with likely and possible pulmonary hypertension when compared to NT-proBNP. In multivariate analysis, the global model was better related to galectin-3 than to NT-proBNP levels (R²=0.61 vs. 0.31, p<0.001). Moreover, in contrast to NT-proBNP levels, correlations between galectin-3 levels and RV dysfunction, as assessed by the E/E' ratio and RV ejection fraction, persisted after adjustment for cardiovascular risk factors and COPD-induced inflammation.

CONCLUSION

In patients with COPD-associated pulmonary hypertension presenting with acutely aggravated dyspnoea, galectin-3 levels are predictive of RV dysfunction and correlate better with RV dysfunction parameters compared to NT-proBNP.

摘要

目的

评估慢性阻塞性肺疾病(COPD)合并肺动脉高压且急性加重期呼吸困难患者的超声心动图右心室(RV)结构和功能参数与半乳糖凝集素-3水平之间的关联。

材料与方法

我们对40例COPD患者和40名年龄及性别匹配的健康志愿者(平均年龄59±6岁)进行了一项前瞻性研究,测量半乳糖凝集素-3和NT-proBNP血清水平以及特定的超声心动图参数。

结果

与健康志愿者相比,COPD合并收缩期肺动脉压升高患者的半乳糖凝集素-3水平显著更高,并且与NT-proBNP相比,在区分可能患有和疑似患有肺动脉高压的患者方面表现更佳。在多变量分析中,整体模型与半乳糖凝集素-3水平的相关性优于与NT-proBNP水平的相关性(R²=0.61对0.31,p<0.001)。此外,与NT-proBNP水平不同,在调整心血管危险因素和COPD诱导的炎症后,通过E/E'比值和RV射血分数评估的半乳糖凝集素-3水平与RV功能障碍之间的相关性仍然存在。

结论

在COPD相关性肺动脉高压且急性加重期呼吸困难的患者中,半乳糖凝集素-3水平可预测RV功能障碍,并且与RV功能障碍参数的相关性优于NT-proBNP。

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