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Galectin-3 Levels in Patients with Chronic Constrictive Pericarditis
Fábio Fernandes1,2, Dirceu Thiago Pessoa de Melo1, Felix José Alvarez Ramires1,2
1HC, FM, USP, São Paulo, SP, Brasil.
Insights
Galectin-3 (Gal-3) levels were normal in patients with chronic constrictive pericarditis (CCP) before surgery. Post-surgery, Gal-3 correlated with exercise intolerance, suggesting its prognostic value in CCP patients.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Galectin-3 (Gal-3) is a proinflammatory and profibrotic molecule linked to heart failure pathogenesis.
- The role of Gal-3 in chronic constrictive pericarditis (CCP) remains unclear.
- This study investigates Gal-3 in CCP patients undergoing pericardiectomy.
Purpose of the Study:
- To assess plasma Gal-3 levels in CCP patients.
- To correlate Gal-3 with clinical, functional, and histological parameters.
- To evaluate Gal-3's role in exercise capacity before and after pericardiectomy.
Main Methods:
- Prospective evaluation of 25 symptomatic CCP patients and 21 healthy controls.
- Measurements included plasma Gal-3, B-type natriuretic peptide (BNP), echocardiography, cardiac MRI, and cardiopulmonary exercise testing (CPET).
- CPET was repeated 6 months post-pericardiectomy.
Main Results:
- CCP patients showed no significant difference in Gal-3 levels compared to controls.
- Pre-pericardiectomy Gal-3 did not correlate with BNP, imaging, or histological findings.
- Post-pericardiectomy, Gal-3 significantly correlated with reduced exercise duration and test time (r = -0.79, p < 0.001).
Conclusions:
- CCP patients exhibit normal plasma Gal-3 levels.
- Gal-3 does not correlate with disease severity or function before pericardiectomy.
- Post-pericardiectomy Gal-3 levels may predict exercise intolerance and prognosis.
Abstract:
Background Galectin-3 (Gal-3) is a proinflammatory, profibrotic molecule implicated in the pathogenesis of heart failure. The role of Gal-3 in patients with chronic constrictive pericarditis (CCP) is not clear. Objective The aim of this study was to assess plasma Gal-3 in patients with CCP and correlate it with clinical, functional and histologic parameters. Methods We prospectively evaluated 25 symptomatic patients with CCP referred for pericardiectomy and 21 healthy controls. Patients underwent clinical assessment, Gal-3 and B-type natriuretic peptide (BNP) measurements, echocardiography, cardiac magnetic resonance imaging and cardiopulmonary exercise test (CPET) at baseline. Six months after pericardiectomy CPET was repeated. An alpha error < 5% was considered statistically significant, with a confidence interval of 95%. Results Twenty-five patients with a median age of 45 years were included. Etiology was mainly idiopathic (n = 19, 76%); and 14 (56%) patients had NYHA functional class III/IV. Median BNP and Gal-3 were 143 (89-209) pg/dL and 14.8 (9.7-17.2) ng/mL, respectively. Gal-3 levels were not significantly higher in CCP patients than in control (p = 0.22). There were no significant correlations of Gal-3 with BNP, echocardiographic and cardiac magnetic resonance measures and histological findings. After pericardiectomy, it was found a statistically significant correlation between Gal-3 and the CPTE measures test duration (r = -0.79; p < 0.001) and exercise time (r = -0.79; p < 0.001). Conclusions Patients with CCP had normal levels of Gal-3 as compared to the controls. Gal-3 did not correlate with morphological and functional measures before pericardiectomy. However, the associations between Gal-3 and exercise intolerance after pericardiectomy may suggest a role of Gal-3 in prognosis prediction after pericardiectomy. (Arq Bras Cardiol. 2020; 114(4):683-689).
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