HC, FM, USP, São Paulo, SP, Brasil.
Instituto de Medicina Tropical de São Paulo São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2020 Apr;114(4):683-689. doi: 10.36660/abc.20190152. Epub 2020 May 29.
Background Galectin-3 (Gal-3) is a proinflammatory, profibrotic molecule implicated in the pathogenesis of heart failure. The role of Gal-3 in patients with chronic constrictive pericarditis (CCP) is not clear. Objective The aim of this study was to assess plasma Gal-3 in patients with CCP and correlate it with clinical, functional and histologic parameters. Methods We prospectively evaluated 25 symptomatic patients with CCP referred for pericardiectomy and 21 healthy controls. Patients underwent clinical assessment, Gal-3 and B-type natriuretic peptide (BNP) measurements, echocardiography, cardiac magnetic resonance imaging and cardiopulmonary exercise test (CPET) at baseline. Six months after pericardiectomy CPET was repeated. An alpha error < 5% was considered statistically significant, with a confidence interval of 95%. Results Twenty-five patients with a median age of 45 years were included. Etiology was mainly idiopathic (n = 19, 76%); and 14 (56%) patients had NYHA functional class III/IV. Median BNP and Gal-3 were 143 (89-209) pg/dL and 14.8 (9.7-17.2) ng/mL, respectively. Gal-3 levels were not significantly higher in CCP patients than in control (p = 0.22). There were no significant correlations of Gal-3 with BNP, echocardiographic and cardiac magnetic resonance measures and histological findings. After pericardiectomy, it was found a statistically significant correlation between Gal-3 and the CPTE measures test duration (r = -0.79; p < 0.001) and exercise time (r = -0.79; p < 0.001). Conclusions Patients with CCP had normal levels of Gal-3 as compared to the controls. Gal-3 did not correlate with morphological and functional measures before pericardiectomy. However, the associations between Gal-3 and exercise intolerance after pericardiectomy may suggest a role of Gal-3 in prognosis prediction after pericardiectomy. (Arq Bras Cardiol. 2020; 114(4):683-689).
半乳糖凝集素-3（Gal-3）是一种促炎、促纤维化的分子，与心力衰竭的发病机制有关。Gal-3 在慢性缩窄性心包炎（CCP）患者中的作用尚不清楚。目的：本研究旨在评估 CCP 患者的血浆 Gal-3 水平，并将其与临床、功能和组织学参数相关联。方法：我们前瞻性评估了 25 例因心包切除术而就诊的有症状的 CCP 患者和 21 例健康对照者。患者在基线时接受临床评估、Gal-3 和 B 型利钠肽（BNP）测量、超声心动图、心脏磁共振成像和心肺运动试验（CPET）。心包切除术后 6 个月重复 CPET。统计显著性的 α 错误<5%，置信区间为 95%。结果：共纳入 25 例中位年龄为 45 岁的患者。病因主要为特发性（n=19，76%）；14 例（56%）患者 NYHA 心功能分级为 III/IV 级。中位 BNP 和 Gal-3 分别为 143（89-209）pg/dL 和 14.8（9.7-17.2）ng/mL。CCP 患者的 Gal-3 水平与对照组相比无显著差异（p=0.22）。Gal-3 与 BNP、超声心动图和心脏磁共振测量值以及组织学发现均无显著相关性。心包切除术后，Gal-3 与 CPTE 测量的试验持续时间（r=-0.79；p<0.001）和运动时间（r=-0.79；p<0.001）之间存在统计学显著相关性。结论：与对照组相比，CCP 患者的 Gal-3 水平正常。Gal-3 在心包切除术之前与形态和功能测量值不相关。然而，心包切除术后 Gal-3 与运动不耐受之间的关联可能表明 Gal-3 在心包切除术后预后预测中的作用。
