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Clinical Implications of Plasma Galectin-3 in Heart Failure With Preserved Ejection Fraction: A Meta-Analysis
Yujiao Shi1, Guoju Dong2,3, Jiangang Liu3
1Department of Post-graduate Institute, Chinese Academy of Traditional Chinese Medicine, Beijing, China.
Insights
High plasma Galectin-3 (Gal-3) levels predict new-onset heart failure with preserved ejection fraction (HFpEF) and adverse outcomes in HFpEF patients. Gal-3 also correlates with cardiac structural abnormalities and diastolic dysfunction severity.
Area of Science:
- Cardiology
- Biomarker Research
- Public Health
Background:
- Heart failure with preserved ejection fraction (HFpEF) presents a growing public health challenge.
- Existing data on the clinical utility of plasma Galectin-3 (Gal-3) in HFpEF are conflicting.
- This meta-analysis evaluates Gal-3's role in predicting HFpEF onset, adverse events, and cardiac dysfunction.
Approach:
- A comprehensive meta-analysis was conducted using data from PubMed, Embase, Scopus, and Web of Science up to November 30, 2021.
- Studies correlating plasma Gal-3 with HFpEF incidence, clinical outcomes, and echocardiographic parameters were systematically reviewed.
- Twenty-four papers comprising 27 studies were included in the final analysis.
Key Points:
- Elevated plasma Gal-3 levels are significantly associated with an increased risk of new-onset HFpEF.
- High Gal-3 is linked to a greater risk of adverse outcomes in HFpEF patients, including all-cause death and HF hospitalizations.
- Plasma Gal-3 shows a strong correlation with echocardiographic markers of left ventricular diastolic dysfunction (LVDD), such as the E/e ratio and deceleration time (DT).
Conclusions:
- Plasma Gal-3 may serve as a valuable additional predictor for the development of HFpEF.
- It can also help identify HFpEF patients at higher risk for adverse prognosis, including mortality and hospitalization.
- Gal-3 levels correlate with the severity of LVDD in HFpEF populations, offering insights into cardiac structural abnormalities.
Background:
Heart failure with preserved ejection fraction (HFpEF) is an increasing public health concern. Currently, data regarding the clinical application value of plasma Galectin-3 (Gal-3) in HFpEF are contradictory. Therefore, we performed the following meta-analysis to appraise the clinical implications of serum Gal-3 in HFpEF, including its capacity to predict new-onset disease, long-term unfavorable endpoints, and the degree of cardiac structural abnormality and left ventricular diastolic dysfunction (LVDD).
Methods:
PubMed, Embase, Scopus, and Web of Science were retrieved exhaustively from their inception until November 30, 2021, to obtain studies assessing the correlation between plasma Gal-3 and the clinical features of HFpEF (new-onset HFpEF, adverse outcomes, and echocardiographic parameters related to abnormal cardiac structure and LVDD).
Results:
A total of 24 papers containing 27 studies were ultimately included in the present research. The results of the meta-analysis revealed that high plasma Gal-3 levels are strongly associated with the following clinical characteristics of HFpEF: (i) the increased risk of new-onset HFpEF (HR: 1.11; 95% CI: 1.04-1.19; p = 0.910, I2 = 0%; P = 0.002); (ii) the high risk of adverse outcomes of HFpEF patients [all-cause death (HR: 1.55; 95% CI: 1.27-1.87; p = 0.138, I2 = 42%; P = 0.000) and the composite events [all-cause death and HF hospitalization (HR: 1.50; 95% CI: 1.30-1.74; p = 0.001, I2 = 61%; P = 0.000) or cardiovascular (CV) death and HF hospitalization (HR: 1.71; 95% CI: 1.51-1.94; p = 0.036, I2 = 58%; P = 0.000)]; (iii) echocardiographic indices [E/e ratio (r: 0.425, 95% CI: 0.184-0.617; p = 0.000, I2 = 93%; P = 0.001) and DT (r: 0.502, 95% CI: 0.061-0.779; p = 0.001 I2 = 91%; P = 0.027)].
Conclusions:
Plasma Gal-3 might be employed as an additional predictor for new-onset HFpEF, the adverse prognosis in HFpEF patients (all-cause death, the composite endpoints of all-cause death and HF hospitalization or CV death and HF hospitalization), and the severity of LVDD in HFpEF populations.
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