Changes And Significance Of Plasma Gal-3 Levels In Patients With Left Heart Failure And Pulmonary Hypertension

Heart failure is a common cardiovascular disease in elderly patients.Heart failure is the end-stage manifestation of coronary heart disease（CHD）,hypertension,dilated cardiomyopathy（DCM）and so on.Heart failure,as a very serious clinical disease,is often accompanied by lung,liver,kidney and other target organ damage.Pulmonary hypertension is the most common complication of left heart disease,so left heart associated pulmonary hypertension is the most common type of pulmonary hypertension,its morbidity and mortality are very high.The diagnosis of left heart associated pulmonary hypertension is often ignored in current clinical work.Plasma Gal-3 is an important mediator of inflammatory response and plays an important role in the development of heart failure.Studies have shown that plasma Gal-3 may be a new indicator of the diagnosis of heart failure.In myocardial tissue of heart failure,macrophages were activated and plasma Gal-3 was synthesized in large quantities.The higher the plasma Gal-3 level in patients with heart failure,the higher the hospitalization rate and mortality were.Therefore,plasma Gal-3 has prognostic effect on patients with heart failure.The purpose of this study was to investigate the significance of plasma Gal-3 in patients with left heart failure complicated with pulmonary hypertension by measuring plasma Gal-3 level.Objective:To observe the relationship between plasma Gal-3 level and pulmonary artery pressure in patients with left heart failure and pulmonary hypertension.To investigate the diagnosis and significance of plasma Gal-3in patients with left heart failure complicated with pulmonary hypertension.Methods:From September 2015 to September 2017,150 patients with left ventricular failure were selected from the geriatric department of Hospital.The Bernoulli equation was used to estimate the pulmonary hypertension level in patients.According to pulmonary artery pressure（PASP）,39 patients with normal pulmonary artery pressure（PASP<35mmHg）,36 patients with mild pulmonary hypertension（PASP 35mmHg）and 75 patients with moderate and severe pulmonary hypertension（PASP>45mmHg）were divided into three groups:PASP group（n=39）,PASP group（n=36）and PASP group（n=75）.Determination of plasma Gal-3 and brain natriuretic peptide（BNP）levels in three groups by ELISA assay.The right ventricular diameter,left atrial diameter and left ventricular diameter were measured by echocardiography.Linear correlation Analysis of the relationship between Plasma Gal-3 and Pulmonary artery pressure and other Indexes.The difference was statistically significant（P<0.05）.Results:1 Comparison of general data among the three groupsThe mean age of patients with normal pulmonary artery pressure was（67.3±13.0）,including 21 males and 18 females,including 15 patients with coronary heart disease,3 patients with hypertensive heart disease,4 patients with alcoholic cardiomyopathy,9 patients with dilated cardiomyopathy and 8patients with valvular heart disease.The average age of patients with mild pulmonary hypertension was（69.5±15.4）,including 17 males and 19females,including 13 cases of coronary heart disease,3 cases of hypertensive heart disease,4 cases of alcoholic cardiomyopathy,10 cases of dilated cardiomyopathy,6 cases of valvular heart disease.The mean age of patients with moderate and severe pulmonary hypertension was（70.7±13.9）,including 39 males and 36 females,including 27 patients with coronary heart disease,3 patients with hypertensive heart disease,4 patients with alcoholic cardiomyopathy,27 patients with dilated cardiomyopathy and 14 patients with valvular heart disease.There was no significant difference in age,sex and etiology among the three groups（P>0.05）.2 Comparison of plasma Gal-3 BNP levels in three groups of PASPThe PASP of normal pulmonary artery pressure group,mild pulmonary hypertension group and moderate and severe pulmonary hypertension group were（22.10±4.55）mmHg,（39.61±2.87）mmHg and（58.09±6.90）mmHg,respectively.The plasma levels of Gal-3 were（25.7±3.4）pg/mL,（36.1±7.5）pg/mL and（53.4±3.8）pg/mL,respectively.The plasma BNP levels were（349.2±188.8）g/mL,（627.7±304.8）g/mL,（1356.2±506.1）g/mL,respectively.Compared with normal pulmonary artery pressure group,PASP,plasma Gal-3 BNP levels in mild pulmonary hypertension group and moderate and severe pulmonary hypertension group were lower than those in normal pulmonary artery pressure group（P<0.05）.There was significant difference between moderate and severe pulmonary hypertension group and mild pulmonary hypertension group（P<0.05）.3 Comparison of echocardiographic indexes among the three groupsThe left ventricular internal diameter of normal pulmonary artery pressure group,mild pulmonary hypertension group and moderate and severe pulmonary hypertension group were（48.9±5.0）mm,（50.9±4.8）mm,（49.7±5.5）mm,respectively.The internal diameter of the left atrium was（27.4±4.0）mm,（28.9±4.0）mm,（28.9±3.8）mm,respectively.The diameter of the right ventricle is（15.3±2.9）mm、（20.5±2.5）mm、（24.6±1.6）mm.Left atrial diameter and left ventricular diameter were compared among the three groups,P>0.05;The right ventricular diameter in the normal pulmonary arterial pressure group was significantly lower than that in the mild pulmonary hypertension group and the moderate and severe pulmonary hypertension group,P<0.05;The diameter of right ventricle in moderate and severe pulmonary hypertension group was significantly higher than that in mild pulmonary hypertension group and normal pulmonary artery pressure group.P<0.05.4 The correlation between plasma Gal-3 and other indicatorsPlasma Gal-3 was positively correlated with PASP,plasma BNPand right ventricular diameter.（The correlation coefficients are r₁=0.860,r₂=0.763,r₃=0.771,P<0.05）.There was a correlation between plasma Gal-3and left atrial diameter,but the correlation was weak,（r₄=0.119,P<0.05）.There was no significant correlation between left ventricular diameter and plasma Gal-3,（r₅=0.056,P>0.05）.Conclusion:Plasma Gal-3 levels in patients with left heart failure and pulmonary hypertension increased with the increase of pulmonary artery pressure.Gal-3may be involved in the development of the disease.