Shi Yujiao, Dong Guoju, Liu Jiangang, Shuang Xiong, Liu Chunqiu, Yang Chenguang, Qing Wang, Qiao Wenbo
Department of Post-graduate Institute, Chinese Academy of Traditional Chinese Medicine, Beijing, China.
Department of Cardiovascular Internal Medicine, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China.
Front Cardiovasc Med. 2022 Apr 14;9:854501. doi: 10.3389/fcvm.2022.854501. eCollection 2022.
Heart failure with preserved ejection fraction (HFpEF) is an increasing public health concern. Currently, data regarding the clinical application value of plasma Galectin-3 (Gal-3) in HFpEF are contradictory. Therefore, we performed the following meta-analysis to appraise the clinical implications of serum Gal-3 in HFpEF, including its capacity to predict new-onset disease, long-term unfavorable endpoints, and the degree of cardiac structural abnormality and left ventricular diastolic dysfunction (LVDD).
PubMed, Embase, Scopus, and Web of Science were retrieved exhaustively from their inception until November 30, 2021, to obtain studies assessing the correlation between plasma Gal-3 and the clinical features of HFpEF (new-onset HFpEF, adverse outcomes, and echocardiographic parameters related to abnormal cardiac structure and LVDD).
A total of 24 papers containing 27 studies were ultimately included in the present research. The results of the meta-analysis revealed that high plasma Gal-3 levels are strongly associated with the following clinical characteristics of HFpEF: (i) the increased risk of new-onset HFpEF (HR: 1.11; 95% CI: 1.04-1.19; = 0.910, I = 0%; = 0.002); (ii) the high risk of adverse outcomes of HFpEF patients [all-cause death (HR: 1.55; 95% CI: 1.27-1.87; = 0.138, I = 42%; = 0.000) and the composite events [all-cause death and HF hospitalization (HR: 1.50; 95% CI: 1.30-1.74; = 0.001, I = 61%; = 0.000) or cardiovascular (CV) death and HF hospitalization (HR: 1.71; 95% CI: 1.51-1.94; = 0.036, I = 58%; = 0.000)]; (iii) echocardiographic indices [E/e ratio (r: 0.425, 95% CI: 0.184-0.617; = 0.000, I = 93%; = 0.001) and DT (r: 0.502, 95% CI: 0.061-0.779; = 0.001 I = 91%; = 0.027)].
Plasma Gal-3 might be employed as an additional predictor for new-onset HFpEF, the adverse prognosis in HFpEF patients (all-cause death, the composite endpoints of all-cause death and HF hospitalization or CV death and HF hospitalization), and the severity of LVDD in HFpEF populations.
射血分数保留的心力衰竭（HFpEF）日益引起公众健康关注。目前，关于血浆半乳糖凝集素-3（Gal-3）在HFpEF中的临床应用价值的数据相互矛盾。因此，我们进行了以下荟萃分析，以评估血清Gal-3在HFpEF中的临床意义，包括其预测新发疾病、长期不良终点以及心脏结构异常程度和左心室舒张功能障碍（LVDD）的能力。
全面检索了PubMed、Embase、Scopus和Web of Science数据库，检索时间从建库至2021年11月30日，以获取评估血浆Gal-3与HFpEF临床特征（新发HFpEF、不良结局以及与心脏结构异常和LVDD相关的超声心动图参数）之间相关性的研究。
本研究最终纳入了24篇包含27项研究的论文。荟萃分析结果显示，血浆Gal-3水平升高与HFpEF的以下临床特征密切相关：（i）新发HFpEF风险增加（HR：1.11；95%CI：1.04-1.19；P = 0.910，I² = 0%；P = 0.002）；（ii）HFpEF患者不良结局风险高[全因死亡（HR：1.55；95%CI：1.27-1.87；P = 0.138，I² = 42%；P = 0.000）以及复合事件[全因死亡和HF住院（HR：1.50；95%CI：1.30-1.74；P = 0.001，I² = 61%；P = 0.000）或心血管（CV）死亡和HF住院（HR：1.71；95%CI：1.51-1.94；P = 0.036，I² = 58%；P = 0.000）]；（iii）超声心动图指标[E/e比值（r：0.425，95%CI：0.184-0.617；P = 0.000，I² = 93%；P = 0.001）和DT（r：0.502，95%CI：0.061-0.779；P = 0.001，I² = 91%；P = 0.027）]。
血浆Gal-3可作为新发HFpEF、HFpEF患者不良预后（全因死亡、全因死亡和HF住院或CV死亡和HF住院的复合终点）以及HFpEF人群LVDD严重程度的额外预测指标。
