Oz Fahrettin, Onur Imran, Elitok Ali, Ademoglu Evin, Altun Ibrahim, Bilge Ahmet Kaya, Adalet Kamil
a Department of Cardiology , Adana Numune Training and Research Hospital , Adana , Turkey.
b Department of Cardiology , Istanbul University, Istanbul School of Medicine , Istanbul , Turkey.
Acta Cardiol. 2017 Aug;72(4):453-459. doi: 10.1080/00015385.2017.1335371. Epub 2017 Jul 14.
Background Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable disorder characterized by fibro-fatty replacement of right ventricular myocytes, increased risk of ventricular arrhythmias, and sudden cardiac death. Galectin-3 (GAL3) is known to play an important role in a number of fibrotic conditions, including cardiac fibrosis. Many studies have focused on the association between GAL3 levels and cardiac fibrosis in heart failure. However, the role of GAL3 in the pathogenesis of ARVD and ventricular arrhythmias has not yet been evaluated thoroughly. The aim of this study was to explore GAL3 levels in patients with ARVD and its association with ventricular arrhythmias. Methods Twenty-nine patients with ARVD and 24 controls were included. All patients with ARVD had an implantable cardiac defibrillator (ICD) for primary or secondary prevention. Ventricular arrhythmia history was obtained from a chart review and ICD data interrogation. Galectin-3 levels were measured using an enzyme-linked immunosorbent assay. Results Patients with ARVD had higher plasma GAL3 levels (16.9 ± 2.6 ng/mL vs 11.3 ± 1.8 ng/mL, P < 0.001) than the control group. Ten patients had sustained or non-sustained ventricular arrhythmias during follow-up. In the multivariable analysis, left ventricular disease involvement (HR: 1.05; 95% CI: [1.01-1.12]; P = 0.03); functional capacity >2 (HR: 1.21; 95% CI: [1.13-1.31]; P < 0.005); and GAL3 levels (HR: 1.05; 95% CI: [1.00-1.11]; P = 0.01) independently predicted VT/VF. Conclusion We demonstrated that serum GAL3 was significantly elevated in patients with ARVD. Also, serum GAL 3 levels could be regarded as a candidate biomarker in the diagnosis of ARVD which needs to be tested in larger prospective studies. In addition, GAL3 levels were higher in patients with VT/VF as compared with those without VT/VF.
背景 致心律失常性右室心肌病(ARVD)是一种遗传性疾病,其特征为右室心肌细胞被纤维脂肪组织替代、室性心律失常风险增加以及心源性猝死。已知半乳糖凝集素-3(GAL3)在包括心脏纤维化在内的多种纤维化疾病中起重要作用。许多研究聚焦于GAL3水平与心力衰竭时心脏纤维化之间的关联。然而,GAL3在ARVD发病机制及室性心律失常中的作用尚未得到充分评估。本研究旨在探讨ARVD患者的GAL3水平及其与室性心律失常的关联。
方法 纳入29例ARVD患者和24例对照。所有ARVD患者均植入了植入式心脏除颤器(ICD)用于一级或二级预防。通过病历回顾和ICD数据查询获取室性心律失常病史。采用酶联免疫吸附测定法测量半乳糖凝集素-3水平。
结果 ARVD患者的血浆GAL3水平(16.9±2.6 ng/mL vs 11.3±1.8 ng/mL,P<0.001)高于对照组。10例患者在随访期间发生持续性或非持续性室性心律失常。在多变量分析中,左心室受累(HR:1.05;95%CI:[1.01 - 1.12];P = 0.03);功能能力>2(HR:1.21;95%CI:[1.13 - 1.31];P<0.005);以及GAL3水平(HR:1.05;95%CI:[1.00 - 1.11];P = 0.01)独立预测室性心动过速/心室颤动。
结论 我们证明ARVD患者血清GAL3显著升高。此外,血清GAL3水平可被视为ARVD诊断中的候选生物标志物,这需要在更大规模的前瞻性研究中进行验证。此外,发生室性心动过速/心室颤动的患者GAL3水平高于未发生室性心动过速/心室颤动的患者。