Stoica Alexandra, Şorodoc Victoriţa, Lionte Cătălina, Jaba Irina M, Costache Irina, Anisie Ecaterina, Tuchiluș Cristina, Rusalim Petriș Ovidiu, Sîrbu Oana, Jaba Elisabeta, Ceasovschih Alexandr, Vâţă Luminiţa, Şorodoc Laurenţiu
1 Gr. T. Popa University of Medicine and Pharmacy, Iași, Romania.
2 Sf. Spiridon Emergency Hospital Iași, Romania.
J Int Med Res. 2019 Jan;47(1):159-172. doi: 10.1177/0300060518798257. Epub 2018 Sep 17.
This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays.
This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients' New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed.
Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients.
The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.
本研究旨在确定使用脑钠肽前体N端（NT-proBNP）和半乳糖凝集素-3的双生物标志物方法是否能优化急性心源性呼吸困难的诊断和风险分层。非典型临床表现和重叠病理需要客观有效的诊断方法以避免治疗延误。
这项前瞻性观察性研究纳入了208例因急性呼吸困难就诊于急诊科的患者。入院时检测NT-proBNP和半乳糖凝集素-3。根据临床表现的病因将患者分为两组：心源性和非心源性呼吸困难。评估患者的纽约心脏协会功能分级、左心室射血分数和出院状态。
61.1%的患者符合急性心力衰竭的诊断标准。NT-proBNP和半乳糖凝集素-3呈强显著相关性。受试者工作特征分析显示，在整个患者组以及高危亚组患者中，两种标志物的曲线下面积相似。
NT-proBNP和半乳糖凝集素-3在总体人群和高危亚组中的诊断性能相当。半乳糖凝集素-3在急性心源性呼吸困难患者中为传统的NT-proBNP增加了诊断价值，其效用在临床情况不明时具有重要意义。
