Lala Radu Ioan, Darabantiu Dan, Pilat Luminita, Puschita Maria
Vasile Goldis West University Arad, Romania.
Arq Bras Cardiol. 2016 Feb;106(2):121-9. doi: 10.5935/abc.20150149. Epub 2016 Jan 12.
Heart failure is accompanied by abnormalities in ventricular-vascular interaction due to increased myocardial and arterial stiffness. Galectin-3 is a recently discovered biomarker that plays an important role in myocardial and vascular fibrosis and heart failure progression.
The aim of this study was to determine whether galectin-3 is correlated with arterial stiffening markers and impaired ventricular-arterial coupling in decompensated heart failure patients.
A total of 79 inpatients with acute decompensated heart failure were evaluated. Serum galectin-3 was determined at baseline, and during admission, transthoracic echocardiography and measurements of vascular indices by Doppler ultrasonography were performed.
Elevated pulse wave velocity and low arterial carotid distensibility are associated with heart failure in patients with preserved ejection fraction (p = 0.04, p = 0.009). Pulse wave velocity, carotid distensibility and Young's modulus did not correlate with serum galectin-3 levels. Conversely, raised galectin-3 levels correlated with an increased ventricular-arterial coupling ratio (Ea/Elv) p = 0.047, OR = 1.9, 95% CI (1.0‑3.6). Increased galectin-3 levels were associated with lower rates of left ventricular pressure rise in early systole (dp/dt) (p=0.018) and raised pulmonary artery pressure (p = 0.046). High galectin-3 levels (p = 0.038, HR = 3.07) and arterial pulmonary pressure (p = 0.007, HR = 1.06) were found to be independent risk factors for all-cause mortality and readmissions.
This study showed no significant correlation between serum galectin-3 levels and arterial stiffening markers. Instead, high galectin-3 levels predicted impaired ventricular-arterial coupling. Galectin-3 may be predictive of raised pulmonary artery pressures. Elevated galectin-3 levels correlate with severe systolic dysfunction and together with pulmonary hypertension are independent markers of outcome.
由于心肌和动脉僵硬度增加，心力衰竭伴有心室 - 血管相互作用异常。半乳糖凝集素 - 3是最近发现的一种生物标志物，在心肌和血管纤维化以及心力衰竭进展中起重要作用。
本研究旨在确定半乳糖凝集素 - 3是否与失代偿性心力衰竭患者的动脉僵硬度标志物及心室 - 动脉耦联受损相关。
共评估了79例急性失代偿性心力衰竭住院患者。在基线时及入院期间测定血清半乳糖凝集素 - 3，进行经胸超声心动图检查及通过多普勒超声测量血管指数。
射血分数保留的患者中，脉搏波速度升高和颈动脉扩张性降低与心力衰竭相关（p = 0.04，p = 0.009）。脉搏波速度、颈动脉扩张性和杨氏模量与血清半乳糖凝集素 - 3水平无相关性。相反，半乳糖凝集素 - 3水平升高与心室 - 动脉耦联比（Ea/Elv）增加相关（p = 0.047，OR = 1.9，95%CI[1.0 - 3.6]）。半乳糖凝集素 - 3水平升高与早期收缩期左心室压力上升速率（dp/dt）降低（p = 0.018）及肺动脉压力升高（p = 0.046）相关。高半乳糖凝集素 - 3水平（p = 0.038，HR = 3.07）和肺动脉压力（p = 0.007，HR = 1.06）被发现是全因死亡率和再入院的独立危险因素。
本研究表明血清半乳糖凝集素 - 3水平与动脉僵硬度标志物之间无显著相关性。相反，高半乳糖凝集素 - 3水平预示心室 - 动脉耦联受损。半乳糖凝集素 - 3可能预测肺动脉压力升高。半乳糖凝集素 - 3水平升高与严重收缩功能障碍相关，并且与肺动脉高压一起是预后的独立标志物。
