Servicio de Cardiología y Unidad de Hemodinámica, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Travesía da Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain.
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Travesía da Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain.
J Mol Med (Berl). 2021 Jul;99(7):943-953. doi: 10.1007/s00109-021-02054-6. Epub 2021 Feb 27.
Post-infarction remodeling is a clinical problem with no curative treatment. Our objective was to search for new biomarkers of cardiac remodeling that have clinical value after ST-segment elevation myocardial infarction (STEMI). This pilot study enrolled 67 consecutive patients with de novo STEMI who underwent revascularization by primary angioplasty. Echocardiography studies of cardiac function were completed during the first 48 h post-STEMI and after 6 months of follow-up. Galectin-3 and soluble receptor for advanced glycation end products (sRAGE) were tested in the peripheral venous blood during the 24 h post-infarction. Cardiac remodeling was defined as changes ≥ 15% in the left ventricular end-systolic volume (LVESV) or > 10% in the left atrial area (LAA). An inverse association was found between galectin-3 (r = - 0.296; p < 0.001) and sRAGE (r = - 0.327; p < 0.001) levels and the basal left ventricle ejection fraction (LVEF). However, only galectin-3 was directly associated with the increase in LVESV (r = 0.389; p = 0.007) and LVEDV (r = 0.314; p = 0.031) during the follow-up. sRAGE was inversely related to the change in LAA (r = - 0.320; p = 0.032). These data are consistent with galectin-3, but not sRAGE levels, as a predictor of left ventricle remodeling (OR 1.036, 95% CI 1.002-1.071; p = 0.039). Galectin-3 and sRAGE levels that were measured during hospitalization are inversely related to basal LVEF after a STEMI. Galectin-3 levels are a predictor of adverse post-STEMI LV remodeling, whereas sRAGE levels exhibited an inverse relationship with left atrial remodeling. KEY MESSAGES: Post-infarction remodeling is a clinical problem with no curative treatment. New biomarkers for remodeling after acute myocardial infarction were explored. Early post-STEMI galectin-3 and soluble RAGE are inversely related with left ventricle function. Galectin-3 levels were predictors of adverse post-STEMI left ventricle remodeling. Soluble RAGE levels were associated with left atrial remodeling.
心肌梗死后重构是一种临床问题，目前尚无治愈方法。本研究旨在寻找新的心肌梗死后重构标志物，这些标志物在 ST 段抬高型心肌梗死（STEMI）后具有临床价值。这项前瞻性研究纳入了 67 例接受直接经皮冠状动脉介入治疗的新发 STEMI 患者。在 STEMI 后 48 小时内和 6 个月的随访期间进行心脏功能超声心动图检查。在心肌梗死后 24 小时内检测外周静脉血中的半乳糖凝集素-3 和晚期糖基化终产物可溶性受体（sRAGE）。心脏重构定义为左心室收缩末期容积（LVESV）变化≥15%或左心房面积（LAA）变化>10%。结果发现，半乳糖凝集素-3（r = - 0.296；p < 0.001）和 sRAGE（r = - 0.327；p < 0.001）水平与基础左心室射血分数（LVEF）呈负相关。然而，只有半乳糖凝集素-3与随访期间 LVESV（r = 0.389；p = 0.007）和 LVEDV（r = 0.314；p = 0.031）的增加直接相关。sRAGE 与 LAA 的变化呈负相关（r = - 0.320；p = 0.032）。这些数据与半乳糖凝集素-3一致，但与 sRAGE 水平不一致，提示其为左心室重构的预测因子（OR 1.036，95%CI 1.002-1.071；p = 0.039）。STEMI 后住院期间测量的半乳糖凝集素-3 和 sRAGE 水平与 STEMI 后基础 LVEF 呈负相关。半乳糖凝集素-3 水平是预测 STEMI 后不良左心室重构的指标，而 sRAGE 水平与左心房重构呈负相关。关键信息：心肌梗死后重构是一种临床问题，目前尚无治愈方法。探索急性心肌梗死后重构的新生物标志物。STEMI 后早期的半乳糖凝集素-3 和可溶性 RAGE 与左心室功能呈负相关。半乳糖凝集素-3 水平是预测 STEMI 后不良左心室重构的指标。可溶性 RAGE 水平与左心房重构相关。
