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半乳糖凝集素-3 反映左心室舒张功能障碍的超声心动图分级。

Galectin-3 Reflects the Echocardiographic Grades of Left Ventricular Diastolic Dysfunction.

机构信息

First Department of Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany: DZHK (German Center for Cardiovascular Research) partner site Mannheim.

Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany.

出版信息

Ann Lab Med. 2018 Jul;38(4):306-315. doi: 10.3343/alm.2018.38.4.306.

Abstract

BACKGROUND

The level of Galectin-3 (Gal-3) protein purportedly reflects an ongoing cardiac fibrotic process and has been associated with ventricular remodeling, which is instrumental in the development of heart failure with preserved ejection fraction (HFpEF) syndrome. The aim of this study was to investigate the potential use of Gal-3 in improved characterization of the grades of diastolic dysfunction as defined by echocardiography.

METHODS

Seventy HFpEF patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Blood samples for measurements of Gal-3 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were collected within 24 hours pre- or post-echocardiographic examination. The classification of patients into subgroups based on diastolic dysfunction grade permitted detailed statistical analyses of the derived data.

RESULTS

The Gal-3 serum levels of all patients corresponded to echocardiographic indices, suggesting HFpEF (E/A, P=0.03 and E/E', P=0.02). Gal-3 was also associated with progressive diastolic dysfunction, and increased levels corresponded to the course of disease (P=0.012). Detailed analyses of ROC curves suggested that Gal-3 levels could discriminate patients with grade III diastolic dysfunction (area under the curve [AUC]=0.770, P=0.005).

CONCLUSIONS

Gal-3 demonstrates remarkable effectiveness in the diagnosis of patients suffering from severe grade diastolic dysfunction. Increasing levels of Gal-3 possibly reflect the progressive course of HFpEF, as classified by the echocardiographic grades of diastolic dysfunction.

摘要

背景

Galectin-3(Gal-3)蛋白水平据称反映了持续的心脏纤维化过程,并与心室重构有关,后者是射血分数保留型心力衰竭(HFpEF)综合征发展的关键。本研究旨在探讨 Gal-3 在改善超声心动图定义的舒张功能障碍分级特征中的潜在应用。

方法

本前瞻性单中心研究纳入了 70 名接受常规超声心动图检查的 HFpEF 患者。在超声心动图检查前或后 24 小时内采集血样,用于测量 Gal-3 和氨基末端脑利钠肽前体(NT-proBNP)。根据舒张功能障碍分级将患者分组,以便对得出的数据进行详细的统计分析。

结果

所有患者的 Gal-3 血清水平均与超声心动图指标相关,提示 HFpEF(E/A,P=0.03 和 E/E',P=0.02)。Gal-3 还与进行性舒张功能障碍相关,且水平升高与疾病进程相关(P=0.012)。ROC 曲线的详细分析表明,Gal-3 水平可区分舒张功能障碍 III 级患者(曲线下面积 [AUC]=0.770,P=0.005)。

结论

Gal-3 在诊断患有严重舒张功能障碍的患者方面具有显著效果。Gal-3 水平的升高可能反映了 HFpEF 按照舒张功能障碍的超声心动图分级的进展过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35bf/5895859/bb7ed0fadca3/alm-38-306-g001.jpg

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