Yang Xinglin, Huang Jin, Zhang Jinghong, Li Jian, Tian Zhuang
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
J Cardiovasc Dev Dis. 2024 Jun 29;11(7):202. doi: 10.3390/jcdd11070202.
Amyloid light-chain (AL) amyloidosis is a multisystem disorder, with cardiac amyloid infiltration being a prevalent manifestation. This study aimed to explore the prognostic value of galectin-3 (Gal-3), a soluble marker associated with fibrosis, inflammation, heart failure, and kidney injury, in patients with cardiac AL amyloidosis.
A total of 60 patients who were diagnosed with cardiac AL amyloidosis from January 2015 to May 2018 were enrolled. The prognostic value of Gal-3 was assessed. Receiver operating characteristic (ROC) curves were used to evaluate the predictive accuracy of Gal-3. A Gal-3 cut-off value was identified to predict survival rates.
The ROC curves demonstrated a moderate predictive accuracy of Gal-3 for 0.5- and 5-year survival, with area under the curve (AUC) values of 0.722 and 0.788, respectively. A Gal-3 cut-off value of 15.154 ng/mL was found to predict survival. Kaplan-Meier survival analysis revealed a significant difference in mean overall survival between patients with Gal-3 levels below and above the established cut-off (69.2 months versus 42.1 months, respectively; = 0.036). Multivariate analysis confirmed that Gal-3 > 15.154 ng/mL remained an independent predictor of survival (HR 2.451, 95% CI 1.017-5.910, = 0.046).
This study suggests that Gal-3 holds independent prognostic value for survival in patients with cardiac AL amyloidosis. Gal-3 could potentially enhance the prognostic capabilities of the current soluble markers, thereby improving the management of cardiac AL amyloidosis. However, further validation in larger prospective studies is warranted.
淀粉样轻链（AL）淀粉样变性是一种多系统疾病，心脏淀粉样蛋白浸润是常见表现。本研究旨在探讨半乳糖凝集素-3（Gal-3）在心脏AL淀粉样变性患者中的预后价值，Gal-3是一种与纤维化、炎症、心力衰竭和肾损伤相关的可溶性标志物。
纳入2015年1月至2018年5月期间诊断为心脏AL淀粉样变性的60例患者。评估Gal-3的预后价值。采用受试者工作特征（ROC）曲线评估Gal-3的预测准确性。确定Gal-3的临界值以预测生存率。
ROC曲线显示Gal-3对0.5年和5年生存率具有中等预测准确性，曲线下面积（AUC）值分别为0.722和0.788。发现Gal-3临界值为15.154 ng/mL可预测生存。Kaplan-Meier生存分析显示，Gal-3水平低于和高于既定临界值的患者平均总生存期存在显著差异（分别为69.2个月和42.1个月；P = 0.036）。多变量分析证实，Gal-3>15.154 ng/mL仍然是生存的独立预测因子（HR 2.451，95%CI 1.017 - 5.910，P = 0.046）。
本研究表明，Gal-3对心脏AL淀粉样变性患者的生存具有独立的预后价值。Gal-3可能会增强当前可溶性标志物的预后能力，从而改善心脏AL淀粉样变性的管理。然而，需要在更大规模的前瞻性研究中进行进一步验证。
