Scelsi Laura, Ghio Stefano, Matrone Benedetta, Mannucci Letizia, Klersy Catherine, Valaperta Serenella, Turco Annalisa, Greco Alessandra, Derosa Giuseppe, Oltrona Visconti Luigi
Division of Cardiology, Fondazione IRCCS Policlinico S.Matteo, 27100 Pavia, Italy.
Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico S.Matteo, 27100 Pavia, Italy.
Diagnostics (Basel). 2020 Oct 22;10(11):857. doi: 10.3390/diagnostics10110857.
Galectin-3 is a circulating biomarker of fibrosis whose prognostic role in pulmonary arterial hypertension (PAH) has not been fully explored. We undertook a pilot study to evaluate the relationship between galectin-3 plasma levels and validated risk scores in PAH. The study included 70 PAH patients admitted to a single referral center from June 2016 to June 2018. Patients were stratified according to the REVEAL 2.0 risk score, according to the parameters suggested by the European Society of Cardiology and European Respiratory Society (ESC/ERS) Guidelines, and according to a focused echocardiographic assessment of right heart performance. The association between galectin-3 levels and risk profiles was evaluated by generalized linear regression model with adjustment for etiology. Galectin-3 plasma levels increased linearly in the three risk strata based on the REVEAL 2.0 score (from 16.0 ± 5.7 in low-risk to 22.4 ± 6.3 in intermediate-risk and in 26.9 ± 7.7 ng/mL in high-risk patients ( for trend < 0.001). Galectin-3 levels were significantly lower in low-risk patients defined according to the prognostic parameters of ESC/ERS Guidelines (delta between low-risk and intermediate/high-risk = -9.3, 95% CI -12.8 to -5.8, < 0.001, < 0.001). Additionally, galectin-3 levels were lower in the low-risk profile defined on the basis of the echocardiographic evaluation of right heart performance (delta between low-risk and intermediate-/high-risk = -6.3, 95% CI -9.9 to -2.7, = 0.001). Galectin-3 plasma levels are directly associated with several risk profiles in PAH patients. The prognostic role of this biomarker in PAH is worthwhile to be explored in larger prospective studies.
半乳糖凝集素-3是一种纤维化的循环生物标志物,其在肺动脉高压(PAH)中的预后作用尚未得到充分研究。我们进行了一项初步研究,以评估PAH患者血浆半乳糖凝集素-3水平与验证后的风险评分之间的关系。该研究纳入了2016年6月至2018年6月在单一转诊中心收治的70例PAH患者。根据REVEAL 2.0风险评分、欧洲心脏病学会和欧洲呼吸学会(ESC/ERS)指南建议的参数以及对右心功能的重点超声心动图评估对患者进行分层。通过广义线性回归模型评估半乳糖凝集素-3水平与风险特征之间的关联,并对病因进行校正。根据REVEAL 2.0评分,半乳糖凝集素-3血浆水平在三个风险分层中呈线性增加(低风险患者为16.0±5.7,中风险患者为22.4±6.3,高风险患者为26.9±7.7 ng/mL;趋势P<0.001)。根据ESC/ERS指南的预后参数定义的低风险患者中,半乳糖凝集素-3水平显著较低(低风险与中/高风险之间的差值=-9.3,95%CI -12.8至-5.8,P<0.001,P<0.001)。此外,根据右心功能的超声心动图评估定义的低风险特征中,半乳糖凝集素-3水平较低(低风险与中/高风险之间的差值=-6.3,95%CI -9.9至-2.7,P=0.001)。PAH患者的半乳糖凝集素-3血浆水平与多种风险特征直接相关。这种生物标志物在PAH中的预后作用值得在更大规模的前瞻性研究中进行探索。