Galectin-3 and Strain Imaging for Early Heart Failure Prediction After First Myocardial Infarction

Area of Science:

• Cardiology
• Biomarker Research
• Medical Imaging

Background:

• Galectin-3 (Gal-3) is a fibrosis biomarker implicated in post-infarction cardiac remodeling.
• The short-term prognostic significance of Gal-3 following acute myocardial infarction (MI) requires further elucidation.
• Assessing Gal-3 in conjunction with advanced echocardiographic parameters may enhance prognostic accuracy.

Purpose of the Study:

• To determine the prognostic value of serum Gal-3 for new-onset heart failure (HF) in patients experiencing their first acute MI.
• To investigate the association between Gal-3 levels and echocardiographic indicators of myocardial and atrial dysfunction, specifically left ventricular global longitudinal strain (LVGLS) and left atrial reservoir strain.
• To evaluate the combined predictive capability of Gal-3 and LVGLS for in-hospital HF development post-MI.

Main Methods:

• A prospective study involving 105 patients with ST-elevation or non-ST-elevation MI (STEMI/NSTEMI).
• Serum Gal-3 concentrations were measured, and echocardiography was performed to assess LVGLS and left atrial reservoir strain.
• New-onset HF was diagnosed based on clinical symptoms, elevated NT-proBNP levels, and echocardiographic evidence of left ventricular (LV) dysfunction.
• Statistical analyses included correlation, receiver operating characteristic (ROC) analysis, and multivariable regression.

Main Results:

• New-onset HF developed in 32% of patients during a median in-hospital follow-up of 10 days.
• Median Gal-3 levels were 11.6 ng/mL and correlated significantly with echocardiographic measures of myocardial and atrial dysfunction (p=0.001).
• Gal-3 demonstrated moderate discriminative ability for HF prediction (AUC=0.712).
• Both Gal-3 and LVGLS independently predicted HF, and their combination significantly improved discrimination (AUC=0.833).

Conclusions:

• Serum Gal-3 is a valuable early prognostic marker for new-onset HF during the in-hospital phase after acute MI.
• Combining Gal-3 assessment with LVGLS measurement offers a powerful, novel biomarker-imaging approach for predicting post-MI outcomes.
• This combined strategy enhances the early identification of patients at higher risk for HF post-MI.