Istinye State Hospital, Department of Cardiology, Istanbul, Turkey.
Istanbul University, Istanbul Medical School, Department of Cardiology, Istanbul, Turkey.
Rev Port Cardiol (Engl Ed). 2021 Nov;40(11):829-835. doi: 10.1016/j.repce.2021.10.019.
Ventricular arrhythmias are caused by scar tissue in patients with ischemic dilated cardiomyopathy. The gold standard imaging technique for detecting scar tissue is magnetic resonance imaging (MRI). However, MRI is not feasible for use as a screening test, and also cannot be used in patients who have received an implantable cardioverter-defibrillator (ICD). In this study, we aimed to assess the association between levels of galectin-3 (Gal-3), which is known to be secreted by scar tissue, and the history of ventricular arrhythmias in patients with ischemic dilated cardiomyopathy who received an ICD.
Nineteen healthy controls and 32 patients who had previously undergone VVI-ICD implantation due to ischemic dilated cardiomyopathy were enrolled in the study. Patients were divided into three groups: the first group including patients who had received no ICD therapies, the second including patients with arrhythmia requiring therapies with no arrhythmia storm, and the third including patients who had arrhythmia storm. We assessed the association between Gal-3 levels and the history of ventricular arrhythmias in these patients.
Gal-3 levels were significantly higher in the patient groups than in the control group (p<0.01). Gal-3 levels of patients with arrhythmias requiring ICD therapies were significantly higher than in patients with ICD not requiring therapies (p=0.02). They were also higher in patients with a history of arrhythmia storm than in patients without shocks (p=0.05). Receiver operating curve analysis showed with 84% sensitivity and 75% specificity that Gal-3 levels over 7 ng/ml indicated ventricular arrhythmia that required therapies.
Gal-3 may be used to further improve risk stratification in patients with ischemic cardiomyopathy who are more prone to developing life-threatening arrhythmias.
室性心律失常是由缺血性扩张型心肌病患者的疤痕组织引起的。检测疤痕组织的金标准成像技术是磁共振成像（MRI）。然而，MRI 不适用于作为筛查试验，也不能用于已植入植入式心脏复律除颤器（ICD）的患者。在这项研究中，我们旨在评估已知由疤痕组织分泌的半乳糖凝集素-3（Gal-3）水平与接受 ICD 的缺血性扩张型心肌病患者室性心律失常病史之间的关系。
研究纳入了 19 名健康对照者和 32 名因缺血性扩张型心肌病而接受过 VVI-ICD 植入的患者。患者分为三组：第一组包括未接受 ICD 治疗的患者，第二组包括需要治疗但无心律失常风暴的心律失常患者，第三组包括发生心律失常风暴的患者。我们评估了 Gal-3 水平与这些患者室性心律失常病史之间的关系。
患者组的 Gal-3 水平明显高于对照组（p<0.01）。需要 ICD 治疗的心律失常患者的 Gal-3 水平明显高于无需 ICD 治疗的患者（p=0.02）。与无电击的患者相比，有过心律失常风暴史的患者 Gal-3 水平也更高（p=0.05）。接受者操作特征曲线分析显示，Gal-3 水平超过 7ng/ml 时具有 84%的敏感性和 75%的特异性，表明需要治疗的室性心律失常。
Gal-3 可用于进一步改善易发生危及生命心律失常的缺血性心肌病患者的风险分层。
