Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA; Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA; Division of Cardiovascular Medicine, San Diego Veterans Affairs Medical Center, San Diego, CA.
J Card Fail. 2023 Mar;29(3):269-277. doi: 10.1016/j.cardfail.2022.09.017. Epub 2022 Nov 1.
Galectin-3, a biomarker of inflammation and fibrosis, can be associated with renal and myocardial damage and dysfunction in patients with acute heart failure (AHF).
We retrospectively analyzed 790 patients with AHF who were enrolled in the AKINESIS study. During hospitalization, patients with galectin-3 elevation (> 25.9 ng/mL) on admission more commonly had acute kidney injury (assessed by KDIGO criteria), renal tubular damage (peak urine neutrophil gelatinase-associated lipocalin [uNGAL] > 150 ng/dL) and myocardial injury (≥ 20% increase in the peak high-sensitivity cardiac troponin I [hs-cTnI] values compared to admission). They less commonly had ≥ 30% reduction in B-type natriuretic peptide from admission to last measured value. In multivariable linear regression analysis, galectin-3 was negatively associated with estimated glomerular filtration rate and positively associated with uNGAL and hs-cTnI. Higher galectin-3 was associated with renal replacement therapy, inotrope use and mortality during hospitalization. In univariable Cox regression analysis, higher galectin-3 was associated with increased risk for the composite of death or rehospitalization due to HF and death alone at 1 year. After multivariable adjustment, higher galectin-3 levels were associated only with death.
In patients with AHF, higher galectin-3 values were associated with renal dysfunction, renal tubular damage and myocardial injury, and they predicted worse outcomes.
半乳糖凝集素-3 是一种炎症和纤维化的生物标志物，可与急性心力衰竭（AHF）患者的肾和心肌损伤及功能障碍相关。
我们回顾性分析了 AKINESIS 研究中纳入的 790 例 AHF 患者。住院期间，入院时半乳糖凝集素-3 升高（> 25.9ng/mL）的患者更常发生急性肾损伤（根据 KDIGO 标准评估）、肾小管损伤（尿液中性粒细胞明胶酶相关脂质运载蛋白[uNGAL]峰值> 150ng/dL）和心肌损伤（与入院时相比，高峰高敏心肌肌钙蛋白 I[hs-cTnI]值升高≥ 20%）。他们不太可能出现入院至最后一次测量值时 B 型利钠肽降低≥ 30%。在多变量线性回归分析中，半乳糖凝集素-3 与估计肾小球滤过率呈负相关，与 uNGAL 和 hs-cTnI 呈正相关。半乳糖凝集素-3 升高与住院期间需要肾脏替代治疗、使用正性肌力药和死亡率相关。在单变量 Cox 回归分析中，半乳糖凝集素-3 升高与因 HF 再住院或死亡的复合终点以及 1 年时单独死亡的风险增加相关。经过多变量调整后，只有半乳糖凝集素-3 水平升高与死亡相关。
在 AHF 患者中，较高的半乳糖凝集素-3 值与肾功能障碍、肾小管损伤和心肌损伤相关，并预测预后较差。
