Caravaca Perez Pedro, González-Juanatey José R, Nuche Jorge, Matute-Blanco Lucia, Serrano Isabel, Martínez Selles Manuel, Vázquez García Rafael, Martínez Dolz Luis, Gómez-Bueno Manuel, Pascual Figal Domingo, Crespo-Leiro María G, García-Osuna Álvaro, Ordoñez-Llanos Jordi, Cinca Cuscullola Juan, Guerra José M, Delgado Juan F
CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
Department of Cardiology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 Octubre (Imas12), Madrid, Spain.
Front Cardiovasc Med. 2022 Apr 7;9:861651. doi: 10.3389/fcvm.2022.861651. eCollection 2022.
Galectin-3 (Gal-3) is an inflammatory marker associated with the development and progression of heart failure (HF). A close relationship between Gal-3 levels and renal function has been observed, but data on their interaction in patients with acute HF (AHF) are scarce. We aim to assess the prognostic relationship between renal function and Gal-3 during an AHF episode.
This is an observational, prospective, multicenter registry of patients hospitalized for AHF. Patients were divided into two groups according to estimated glomerular filtration rate (eGFR): preserved renal function (eGFR ≥ 60 mL/min/1.73 m) and renal dysfunction (eGFR <60 mL/min/1.73 m). Cox regression analysis was performed to evaluate the association between Gal-3 and 12-month mortality.
We included 1,201 patients in whom Gal-3 values were assessed at admission. The median value of Gal-3 in our population was 23.2 ng/mL (17.3-32.1). Gal-3 showed a negative correlation with eGFR (rho = -0.51; < 0.001). Gal-3 concentrations were associated with higher mortality risk in the multivariate analysis after adjusting for eGFR and other prognostic variables [HR = 1.010 (95%-CI: 1.001-1.018); = 0.038]. However, the prognostic value of Gal-3 was restricted to patients with renal dysfunction [HR = 1.010 (95%-CI: 1.001-1.019), = 0.033] with optimal cutoff point of 31.5 ng/mL, with no prognostic value in the group with preserved renal function [HR = 0.990 (95%-CI: 0.964-1.017); = 0.472].
Gal-3 is a marker of high mortality in patients with acute HF and renal dysfunction. Renal function influences the prognostic value of Gal-3 levels, which should be adjusted by eGFR for a correct interpretation.
半乳糖凝集素-3（Gal-3）是一种与心力衰竭（HF）的发生和发展相关的炎症标志物。已观察到Gal-3水平与肾功能之间存在密切关系，但关于它们在急性心力衰竭（AHF）患者中相互作用的数据很少。我们旨在评估AHF发作期间肾功能与Gal-3之间的预后关系。
这是一项针对因AHF住院患者的观察性、前瞻性、多中心登记研究。根据估计肾小球滤过率（eGFR）将患者分为两组：肾功能保留（eGFR≥60 mL/min/1.73 m²）和肾功能不全（eGFR<60 mL/min/1.73 m²）。进行Cox回归分析以评估Gal-3与12个月死亡率之间的关联。
我们纳入了1201例入院时评估了Gal-3值的患者。我们研究人群中Gal-3的中位数为23.2 ng/mL（17.3 - 32.1）。Gal-3与eGFR呈负相关（rho = -0.51；P<0.001）。在调整eGFR和其他预后变量后的多变量分析中，Gal-3浓度与较高的死亡风险相关[风险比（HR）= 1.010（95%置信区间：1.001 - 1.018）；P = 0.038]。然而，Gal-3的预后价值仅限于肾功能不全患者[HR = 1.010（95%置信区间：1.001 - 1.019），P = 0.033]，最佳截断点为31.5 ng/mL，在肾功能保留组中无预后价值[HR = 0.990（95%置信区间：0.964 - 1.017）；P = 0.472]。
Gal-3是急性HF和肾功能不全患者高死亡率的标志物。肾功能影响Gal-3水平的预后价值，应通过eGFR进行调整以获得正确解读。
