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

Galectin-3 (Gal-3), a biomarker of fibrosis, is involved in post-infarction remodelling, but its short-term prognostic value remains uncertain. This study aimed to evaluate the prognostic value of Gal-3 for new-onset heart failure (HF) in first acute myocardial infarction (MI) during the in-hospital phase following MI and to assess its association with advanced echocardiographic indices of myocardial and atrial dysfunction, including left ventricular global longitudinal strain (LVGLS) and left atrial reservoir strain. In this prospective study, 105 consecutive patients with STEMI/NSTEMI (mean age 61 ± 11 years) were enrolled. New-onset HF, defined by symptoms, elevated NT-proBNP, and echocardiographic LV dysfunction, developed in 34 patients (32%) during follow-up of a median of 10 [8-13] days. Median serum Gal-3 concentration was 11.6 [9.5-13.5] ng/mL. Gal-3 correlated with echocardiographic indices of myocardial and atrial dysfunction (p = 0.001). Receiver operating characteristic analysis showed moderate discriminative ability (AUC = 0.712; cut-off > 10.9 ng/mL). In multivariable regression, both Gal-3 and LVGLS independently predicted HF, and their combination improved discrimination (AUC = 0.833). In conclusion, Gal-3, particularly when combined with LVGLS, is a valuable early prognostic marker of new-onset HF during the in-hospital phase of acute MI. The combined assessment of Gal-3 and GLS provides a novel, translational biomarker-imaging approach to post-MI prognosis.