Diagnostic And Predictive Value Of Serum Galectin-3in Patients With Chronic Heart Failure

Background:Cardiovascular diseases has become one of the most occurring diseases thatthreatening the health of society. Chronic heart failure has become a growing cause ofmorbidity and mortality. Many studies show that early diagnosis and accuratejudgement of the severity of heart failure may play an extreme important role intreatment and prognosis. Biological markers such as BNP and NT-proBNP have beenwidely used in evaluation of the incidence and severity of heart failure clinically.However, multiple mechanisms are involved in the pathophysiology process of heartfailure, thus, a single marker may not be sufficient. Combination of several biologicalmarkers may be more reliable. Galectin-3is a new biological marker, which mayparticipate in the regulation of cardiac fibrosis and remodling. Therefore, it can beused in evaluation of the incidence and severity of HF, it can also be used to predictprognosis in patients with HF (the higher level of galectin-3, the greater damage toheart, and the worse prognosis). In this study comparison of the level of galectin-3inCHF and Control, comparison of the level of galectin-3between different NYHAfunctional class sub-groups, correlation analysis between the level of serum galectin-3and LA, LVD and LVEF, correlation analysis between the level of plasma BNP andLA, LVD and LVEF，comparison of the predictive value of galectin-3and BNP inchronic heart failure were invested. Analyse and discuss the significance of galectin-3in chronic heart failure. And compare the diagnositic value of Galectin-3and BNP forCHF in both the sensitivity and specificity.Methods:Patients with chronic heart failure who were admitted to China-Japan UnionHospital of Jilin University between August,2013and Febraury,2014were enrolled inthis study. And according to inclusion and exclusion criteria, we selected48cases,including26female patients and22male patients with an average age of62±7.6.Among of them.24cases of ischemic heart disease,8cases of dilated cardiomyopathy, 3cases of valvular disease and13cases of hypertensive heart disease. Thesignificance of heart failure was determined by NYHA classification, NYHAⅡ had14cases, NYHA Ⅲ had18cases and NYHA Ⅳ had16cases. Meanwhile selectpeople treated in our hospital over the same period,26cases of healthy individuals asa control group with an average of62±5.5, incluing13females and13males.3ml ofblood was taken within24hours after admission of all enrolled patients, The level ofserum galectin-3was determined by sandwich ELISA, the measurement of BNP,fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, serumcreatinine (Scr), blood urea nitrogen(BUN) were done by the same time,Echocardiography was performed to determine the diastolic left atrial diameter (LA),left ventricular end-diastolic diameter (LVD) and left ventricular ejection fraction(LVEF). Data were analyzed by SPSS17.0(SPSS Inc, Chicago, IL, USA) andpresented as mean±standard deviation (SD). Difference between two groups wascompared by t-test and differences among three or more groups were compared byone-way analysis of variance (ANOVA), p <0.05was considered statisticallysignificant. Association of two sets of data was evaluated with Pearson correlationanalysis. Receiver-operating characteristic (ROC) curve was used to analyze thepredictive value of galectin-3or BNP for CHF.Result:The level of serum galectin-3was significantly higher in the CHF groupcompared with that in control; The differences of the level of serum galectin-3between diffrernt sub-groups was statistically significant (p <0.05and p <0.01). Thelevel of serum galectin-3was positively correlated with LA (r=0.465, p <0.01) andLVD (r=0.643, p <0.01), but negatively correlated with LVEF (r=–0.788, p <0.01).The level of plasma BNP was positively correlated with LA (r=0.464, p <0.01) andLVD (r=0.633, p <0.01), but negatively correlated with LVEF (r=–0.799, p <0.01).The level of serum galectin-3was positively correlated with the level of plasma BNP(r=0.855，p﹤0.01). AUC was0.808when the level of serum galectin-3was more than8.61ng/ml. The sensitivity to predict CHF was77.1%, the specificity was92.3%.AUC was0.903when the level of plasma BNP was more than1011pg/ml. The sensitivity to predict CHF was81.6%and the specificity was90.3%.Conclusion:1.The level of serum galectin-3is related to the changes of left heart structureand function, indicating that galectin-3may be involved in the process of leftventricular remodeling in CHF.2.The specificity of galectin-3is higher than BNP in predicting CHF, not thesensitivity.