Ann Lab Med.  2018 Jul;38(4):306-315. 10.3343/alm.2018.38.4.306.

Galectin-3 Reflects the Echocardiographic Grades of Left Ventricular Diastolic Dysfunction

• Ansari U
• Behnes M
• Hoffmann J
• Natale M
• Fastner C
• El-Battrawy I
• Rusnak J
• Kim SH
• Lang S
• Hoffmann U
• Bertsch T
• Borggrefe
• Akin I

• KMID: 2408069
• DOI: http://doi.org/10.3343/alm.2018.38.4.306

Abstract

BACKGROUND
The level of Galectin-3 (Gal-3) protein purportedly reflects an ongoing cardiac fibrotic process and has been associated with ventricular remodeling, which is instrumental in the development of heart failure with preserved ejection fraction (HFpEF) syndrome. The aim of this study was to investigate the potential use of Gal-3 in improved characterization of the grades of diastolic dysfunction as defined by echocardiography.
METHODS
Seventy HFpEF patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Blood samples for measurements of Gal-3 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were collected within 24 hours pre- or post-echocardiographic examination. The classification of patients into subgroups based on diastolic dysfunction grade permitted detailed statistical analyses of the derived data.
RESULTS
The Gal-3 serum levels of all patients corresponded to echocardiographic indices, suggesting HFpEF (E/A, P=0.03 and E/E', P=0.02). Gal-3 was also associated with progressive diastolic dysfunction, and increased levels corresponded to the course of disease (P=0.012). Detailed analyses of ROC curves suggested that Gal-3 levels could discriminate patients with grade III diastolic dysfunction (area under the curve [AUC]=0.770, P=0.005).
CONCLUSIONS
Gal-3 demonstrates remarkable effectiveness in the diagnosis of patients suffering from severe grade diastolic dysfunction. Increasing levels of Gal-3 possibly reflect the progressive course of HFpEF, as classified by the echocardiographic grades of diastolic dysfunction.

Keyword

Galectin-3; Preserved ejection fraction; NT-proBNP; Diastolic dysfunction

MeSH Terms

Classification
Diagnosis
Echocardiography*
Galectin 3*
Heart Failure
Humans
Prospective Studies
ROC Curve
Ventricular Remodeling
Galectin 3

Figure

• 

  Fig. 1 Box plots showing increased levels of Galectin-3 (A) and increased levels of NT-proBNP (B) in patients with different grades of diastolic dysfunction. Significantly highest levels of Galectin-3 and NT-proBNP were noted in Grade III diastolic dysfunction, indicating a progressive increase in their levels along the course of the disease.Abbreviation: NT-proBNP, amino-terminal pro-brain natriuretic peptide.

• 

  Fig. 2 Receiver-operating characteristic (ROC) curve revealing an effective discrimination of patients with diastolic dysfunction III. ROC=diastolic dysfunction grade 3 curve. AUC–Area under the Curve.Abbreviation: NT-proBNP, amino-terminal pro-brain natriuretic peptide.

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