Kotby Alyaa Amal, Youssef Omneya Ibrahim, Elmaraghy Mohamed Omar, El Sharkawy Osama Salah
Pediatrics Department, Faculty of Medicine, Children's Hospital, Ain Shams University, 29dar el ezz, medinet el zahraa, helmeyet el zaytoon, Cairo, 11321, Egypt.
Clinical Pathology Department, Children's Hospital, Ain Shams University, Cairo, Egypt.
Pediatr Cardiol. 2017 Jan;38(1):95-102. doi: 10.1007/s00246-016-1488-2. Epub 2016 Nov 11.
Heart failure (HF) progression has not been studied in pediatric patients as well as HF in patients with a normal ejection fraction (HFNEF). We aimed to evaluate galactin-3 in children with HFNEF and reduced ejection fraction (HFREF) and its correlation to disease severity and progression. This cross-sectional study involved 45 chronic HF patients taking G1a (23 HFNEF children) and G1b (22 HFREF children) compared to 45 age- and sex-matched controls (G2) subjected to history taking, Ross functional HF classification, conventional and tissue Doppler echocardiographic systolic and diastolic function assessment (FS%, E/A, S , E /A , E/E ) and laboratory investigations [glomerular filtration rate, serum galactin-3 level (ELISA)]. The results showed that serum galactin was increased in patients compared to controls (p > 0.001); a cutoff value of 3.5 ng/ml was estimated for HF diagnosis HFNEF patients who had higher galactin-3 levels than HFREF patients, but it did not reach statistical significance (p = 0.194). Galactin-3 levels positively correlated to the Ross HF classification (p = 0.01) and E/E (p = 0.032) and negatively correlated to FS%, S and E /A (p = 0.028, 0.022, 0.043). Galactin-3 levels were significantly reduced in patients receiving spironolactone (p = 0.049). Galactin-3 can be a tool for chronic HF diagnosis and a marker of disease severity and staging in children with HFNEF and HFREF. The role of spironolactone in reducing galactin-3 in pediatric HF requires further research.
与射血分数正常的心力衰竭（HFNEF）患者一样，小儿患者的心力衰竭（HF）进展尚未得到研究。我们旨在评估射血分数正常的心力衰竭（HFNEF）和射血分数降低的心力衰竭（HFREF）患儿的半乳糖凝集素-3及其与疾病严重程度和进展的相关性。这项横断面研究纳入了45例慢性HF患者，其中G1a组（23例HFNEF患儿）和G1b组（22例HFREF患儿），并与45例年龄和性别匹配的对照组（G2）进行比较，对所有研究对象进行病史采集、罗斯HF功能分级、常规和组织多普勒超声心动图收缩和舒张功能评估（FS%、E/A、S、E/A、E/E）以及实验室检查[肾小球滤过率、血清半乳糖凝集素-3水平（ELISA）]。结果显示，与对照组相比，患者血清半乳糖凝集素水平升高（p>0.001）；估计HF诊断的临界值为3.5 ng/ml，HFNEF患者的半乳糖凝集素-3水平高于HFREF患者，但未达到统计学意义（p = 0.194）。半乳糖凝集素-3水平与罗斯HF分级（p = 0.01）和E/E（p = 0.032）呈正相关，与FS%、S和E/A呈负相关（p = 0.028、0.022、0.043）。接受螺内酯治疗的患者半乳糖凝集素-3水平显著降低（p = 0.049）。半乳糖凝集素-3可作为慢性HF诊断的工具，以及HFNEF和HFREF患儿疾病严重程度和分期的标志物。螺内酯在降低小儿HF患者半乳糖凝集素-3水平方面的作用需要进一步研究。
