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Additional value of Galectin-3 to BNP in acute heart failure patients with preserved ejection fraction
Matteo Beltrami1, Gaetano Ruocco1, Amardeep Ghosh Dastidar2
1Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
Insights
Galectin-3 (Gal-3) does not differentiate between heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) but shows prognostic value in HFpEF. This biomarker is linked to diastolic dysfunction and LV stiffness in HFpEF patients.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Management
Background:
- Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of acute heart failure cases.
- Diagnosing HFpEF is challenging with conventional methods; Galectin-3 (Gal-3) is an emerging biomarker for heart failure (HF) risk.
- This study investigates the relationship and prognostic significance of Gal-3, BNP, and renal dysfunction in HFpEF versus HFrEF patients.
Purpose of the Study:
- To analyze the association between Galectin-3 (Gal-3), BNP, and estimated glomerular filtration rate (eGFR) in patients with acute heart failure (AHF).
- To compare these biomarkers and renal function in patients with HFpEF versus HFrEF.
- To determine the prognostic value of Gal-3 in HFpEF, independent of renal dysfunction.
Main Methods:
- 98 patients with AHF were enrolled, with Gal-3, BNP, and eGFR measured within 12 hours of admission.
- Patients were classified into HFpEF (ejection fraction >50%) or HFrEF (ejection fraction <50%) based on echocardiography.
- A 6-month follow-up was conducted to assess patient outcomes.
Main Results:
- Gal-3 levels did not differ significantly between HFpEF and HFrEF groups.
- Gal-3 showed an inverse correlation with renal dysfunction (eGFR) but not with BNP levels.
- Gal-3 was associated with increased diastolic dysfunction and left ventricular (LV) stiffness in HFpEF patients.
- Cox regression analysis revealed that higher Gal-3 levels were an independent predictor of poor outcome in HFpEF, even after adjusting for renal dysfunction.
Conclusions:
- Galectin-3 (Gal-3) cannot distinguish between HFpEF and HFrEF.
- Gal-3 is significantly related to the severity of diastolic dysfunction and LV stiffness in HFpEF.
- Gal-3 holds independent prognostic value in HFpEF patients, irrespective of renal dysfunction.
Background:
Almost half of patients with acute heart failure have preserved ejection fraction (HFpEF). HFpEF is a diagnostic challenge using traditional investigation tools; Galectin-3 (Gal-3) is an emerging biomarker useful in individuals at risk for HF. The aim of our study is to analyse the relation and prognostic value of Gal-3, BNP and renal dysfunction in patients with HFpEF compared to patients with reduced ejection fraction (HFrEF).
Methods:
We enrolled 98 patients with acute heart failure (AHF) and measured Gal-3, BNP, and estimated glomerular filtration rate (eGFR) within 12h of hospital admission. On the basis of echocardiographic findings we divided our sample into two groups: patients with HFrHF (ejection fraction<50%) or HFpEF (ejection fraction>50%). Patients were followed up at 6months.
Results:
No differences in Gal-3 levels were found in the two subgroups (HFrEF: 19.5±5.1ng/mL; HFpEF: 20.5±8.7, p=0.56). Gal-3 was inversely related to renal dysfunction (LogGal-3 vs eGFR: r=-0.30, p=0.01) but did not correlate with LogBNP levels (r=0.07, p=0.55). Gal-3 was associated with more advanced diastolic dysfunction in HFpEF (p=0.009). In addition LogGal-3 was related to diastolic LV stiffness (all patients: r=0.45, p<0.001; HFpEF: r=0.64, p<0.001). Cox regression analysis showed that LogGal-3>1.30 was related to poor outcome independently from renal dysfunction and other risk factors only in HFpEF (univariate HR 23.98 [3.03-89.45]; p<0.001). Adjusted for renal dysfunction (HR 16.32 [1.98-34.09]; p=0.009).
Conclusions:
Gal-3 is not able to distinguish between HFrEF and HFpEF patients. However it is related to diastolic dysfunction severity and LV stiffness in HFpEF. Gal-3 demonstrates a prognostic role independently from renal dysfunction in subjects with HFpEF.
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