Fernandes Fábio, Moreira Carlos Henrique Valente, Oliveira Lea Campos, Souza-Basqueira Marcela, Ianni Barbara Maria, Lorenzo Claudia di, Ramires Felix José Alvarez, Nastari Luciano, Cunha-Neto Edecio, Ribeiro Antonio L, Lopes Renato Delascio, Keating Sheila M, Sabino Ester Cerdeira, Mady Charles
Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil.
Instituto de Infectologia Emilio Ribas, São Paulo, SP - Brasil.
Arq Bras Cardiol. 2021 Feb;116(2):248-256. doi: 10.36660/abc.20190403.
The histopathological characteristics of Chagas disease (ChD) are: presence of myocarditis, destruction of heart fibers, and myocardial fibrosis. Galectin-3 (Gal-3) is a biomarker involved in the mechanism of fibrosis and inflammation that may be useful for risk stratification of individuals with ChD.
We sought to evaluate whether high Gal-3 levels are associated with severe forms of Chagas cardiomyopathy (CC) and whether they are predictive of mortality.
We studied anti-T. cruzi positive blood donors (BD): Non-CC-BD (187 BD without CC with normal electrocardiogram [ECG] and left ventricular ejection fraction [LVEF]); CC-Non-Dys-BD (46 BD with CC with abnormal ECG but normal LVEF); and 153 matched serum-negative controls. This cohort was composed of 97 patients with severe CC (CC-Dys). We used Kruskall-Wallis and Spearman's correlation to test hypothesis of associations, assuming a two-tailed p<0.05 as significant.
The Gal-3 level was 12.3 ng/mL for Non-CC-BD, 12.0 ng/mL for CC-Non-Dys-BD, 13.8 ng/mL for controls, and 15.4 ng/mL for CC-Dys. LVEF<50 was associated with higher Gal-3 levels (p=0.0001). In our linear regression adjusted model, we found association between Gal-3 levels and echocardiogram parameters in T. cruzi-seropositive subjects. In CC-Dys patients, we found a significant association of higher Gal-3 levels (≥15.3 ng/mL) and subsequent death or heart transplantation in a 5-year follow-up (Hazard ratio - HR 3.11; 95%CI 1.21-8.04; p=0.019).
In ChD patients, higher Gal-3 levels were significantly associated with severe forms of the disease and more long-term mortality, which means it may be a useful means to identify high-risk patients. (Arq Bras Cardiol. 2021; 116(2):248-256).
恰加斯病（ChD）的组织病理学特征为：存在心肌炎、心肌纤维破坏和心肌纤维化。半乳糖凝集素-3（Gal-3）是一种参与纤维化和炎症机制的生物标志物，可能有助于对恰加斯病患者进行风险分层。
我们试图评估高Gal-3水平是否与严重形式的恰加斯心肌病（CC）相关，以及它们是否可预测死亡率。
我们研究了抗克氏锥虫阳性献血者（BD）：非CC-BD（187名无CC且心电图[ECG]和左心室射血分数[LVEF]正常的BD）；CC-无功能障碍-BD（46名患有CC且心电图异常但LVEF正常的BD）；以及153名匹配的血清阴性对照。该队列由97名严重CC患者（CC-功能障碍）组成。我们使用Kruskal-Wallis检验和Spearman相关性检验来验证关联假设，假设双侧p<0.05具有统计学意义。
非CC-BD的Gal-3水平为12.3 ng/mL，CC-无功能障碍-BD为12.0 ng/mL，对照组为13.8 ng/mL，CC-功能障碍为15.4 ng/mL。LVEF<50与较高的Gal-3水平相关（p=0.0001）。在我们的线性回归调整模型中，我们发现Gal-3水平与克氏锥虫血清阳性受试者的超声心动图参数之间存在关联。在CC-功能障碍患者中，我们发现较高的Gal-3水平（≥15.3 ng/mL）与5年随访中的后续死亡或心脏移植之间存在显著关联（风险比-HR 3.11；95%CI 1.21-8.04；p=0.019）。
在恰加斯病患者中，较高的Gal-3水平与疾病的严重形式和更高的长期死亡率显著相关，这意味着它可能是识别高危患者的有用手段。（《巴西心脏病学杂志》。2021年；116(2):248-256）
