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Galectin-3 in Children with Chronic Heart Failure with Normal and Reduced Ejection Fraction: Relationship to Disease

Alyaa Amal Kotby1, Omneya Ibrahim Youssef2, Mohamed Omar Elmaraghy3

  • 1Pediatrics Department, Faculty of Medicine, Children's Hospital, Ain Shams University, 29dar el ezz, medinet el zahraa, helmeyet el zaytoon, Cairo, 11321, Egypt.

Pediatric Cardiology
|November 12, 2016
PubMed

Insights

Serum galectin-3 is elevated in children with heart failure (HF), correlating with disease severity. This biomarker aids in diagnosing pediatric HF and staging disease progression in both HF with normal ejection fraction (HFNEF) and HF with reduced ejection fraction (HFREF).

Area of Science:

  • Pediatric Cardiology
  • Biomarkers in Heart Failure
  • Cardiovascular Research

Background:

  • Heart failure (HF) progression in pediatric patients, particularly HF with normal ejection fraction (HFNEF), remains understudied compared to HF with reduced ejection fraction (HFREF).
  • Galectin-3 is implicated as a biomarker in adult HF, but its role in pediatric HF populations requires further investigation.

Purpose of the Study:

  • To evaluate serum galectin-3 levels in children diagnosed with chronic HF, comparing HFNEF and HFREF groups.
  • To assess the correlation between galectin-3 levels and HF disease severity, functional classification, and echocardiographic parameters in pediatric patients.
  • To determine if galectin-3 can serve as a diagnostic or prognostic tool for pediatric HF.

Main Methods:

  • A cross-sectional study involving 45 pediatric HF patients (23 HFNEF, 22 HFREF) and 45 age/sex-matched controls.
  • Assessment included medical history, Ross HF classification, echocardiography (systolic and diastolic function), and laboratory tests (eGFR, serum galectin-3 via ELISA).
  • Statistical analysis compared galectin-3 levels between groups and correlated them with clinical and echocardiographic variables.

Main Results:

  • Serum galectin-3 was significantly elevated in pediatric HF patients compared to controls (p < 0.001), with a proposed diagnostic cutoff of 3.5 ng/ml.
  • Galectin-3 levels positively correlated with HF severity (Ross classification) and diastolic dysfunction (E/E' ratio) and negatively with systolic function (FS%, Sm, Em/Am).
  • While HFNEF patients showed numerically higher galectin-3 than HFREF, this difference was not statistically significant (p=0.194). Galectin-3 levels were reduced in patients receiving spironolactone (p=0.049).

Conclusions:

  • Serum galectin-3 is a potential biomarker for diagnosing chronic HF in children and reflects disease severity and staging in both HFNEF and HFREF.
  • The findings support galectin-3's utility in pediatric cardiology for risk stratification and monitoring HF progression.
  • Further research is warranted to elucidate the effect of spironolactone on galectin-3 levels in pediatric HF.

Keywords:
ChildrenGalactin-3Heart failureNormal ejection fraction

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