scholarly journals The Diagnostic and Prognostic Value of Plasma Galectin 3 in HFrEF Related to the Etiology of Heart Failure

2021 ◽  
Vol 8 ◽  
Author(s):  
Qun Lu ◽  
Ruo-Chen Zhang ◽  
Shu-Ping Chen ◽  
Tao Li ◽  
Ya Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Composite Endpoint ◽  
Left Ventricular ◽  
Shaanxi Province ◽  
Cardiac Tissues ◽  
Reduced Ejection Fraction ◽  
Galectin 3 ◽  
Cox Analysis ◽  
Diagnostic And Prognostic Value

Aim: The aim of present study is to evaluate the diagnostic and prognostic value of plasma galectin 3 (Gal-3) for HF originating from different causes.Methods: We investigated the plasma levels and expression of Gal-3 in cardiac tissues in two transgenic (TG) strains of mice with cardiomyocyte-restricted overexpression of either β2- adrenergic receptor (β2- AR TG) or Mammalian sterile 20-like kinase 1 (Mst1-TG) in the present study. Additionally, 166 patients suffering from heart failure with reduced ejection fraction (HFrEF) in two hospitals within the Shaanxi province were examined in this study. All these patients were treated according to the Chinese HF guidelines of 2014; subsequently, they were followed up for 50 months, and we analyzed the prediction value of baseline Gal-3 to endpoints in these patients.Results: Gal-3 was localized in the cytoplasm and nucleus of cardiomyocytes, often formed aggregates in Mst1-TG mice. Extracellular Gal-3 staining was uncommon in Mst1-TG hearts. However, in β2-AR TG mice, although Gal-3 was also expressed in myocardial cells, it was more highly expressed in interstitial cells (e.g., fibroblasts and macrophages). Plasma Gal-3 was comparable between nTG and Mst1-TG mice. However, plasma Gal-3 was higher in β2-AR TG mice than in nTG mice. In the cohort of HFrEF patients, the median plasma Gal-3 concentration was 158.42 pg/mL. All participants were divided into two groups according to Gal-3 levels. Patients with Gal-3 concentrations above the median were older, and had lower plasma hemoglobin, but higher plasma creatinine, tissue inhibitor of metalloproteinases 1 (TIMP-1), left ventricular end systolic diameter (LVESD), left ventricular end-systolic volumes (LVESV) and end-diastolic, as well as left ventricular end-diastolic volumes (LVEDV). Spearman correlation analysis revealed that Gal-3 was positively correlated with TIMP-1 (r = 0.396, P < 0.001), LVESV (r = 0.181, P = 0.020) and LVEDV (r = 0.190, P = 0.015). The 50-month clinical follow-up revealed 43 deaths, 97 unplanned re-hospitalizations, and 111 composite endpoint events. Cox analysis demonstrated that although Gal-3 did not provide any prognostic value in either total-HF subjects or coronary-heart-disease (CHD) patients, it did provide prognostic value in non-CHD patients.Conclusion: Although plasma Gal-3 is associated with TIMP-1 and echocardiographic parameters, the diagnostic and prognostic value of Gal-3 in HFrEF is determined by the etiology of HF.

Prognostic value of global longitudinal layer specific strain for patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Johnsen ◽  
M Sengeloev ◽  
P Joergensen ◽  
N Bruun ◽  
D Modin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Funding Source ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Abstract Background Novel echocardiographic software allows for layer-specific evaluation of myocardial deformation by 2-dimensional speckle tracking echocardiography. Endocardial, epicardial- and whole wall global longitudinal strain (GLS) may be superior to conventional echocardiographic parameters in predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). Purpose The purpose of this study was to investigate the prognostic value of endocardial-, epicardial- and whole wall GLS in patients with HFrEF in relation to all-cause mortality. Methods We included and analyzed transthoracic echocardiographic examinations from 1,015 patients with HFrEF. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained. A p value in a 2-sided test <0.05 was considered statistically significant. Cox proportional hazards regression models were constructed, and both univariable and multivariable hazard ratios (HRs) were calculated. Results During a median follow-up time of 40 months, 171 patients (16.8%) died. A lower endocardial (HR 1.17; 95% CI (1.11–1.23), per 1% decrease, p<0.001), epicardial (HR 1.20; 95% CI (1.13–1.27), per 1% decrease, p<0.001), and whole wall (HR 1.20; 95% CI (1.14–1.27), per 1% decrease, p<0.001) GLS were all associated with higher risk of death (Figure 1). Both endocardial (HR 1.12; 95% CI (1.01–1.23), p=0.027), epicardial (HR 1.13; 95% CI (1.01–1.26), p=0.040) and whole wall (HR 1.13; 95% CI (1.01–1.27), p=0.030) GLS remained independent predictors of mortality in the multivariable models after adjusting for significant clinical parameters (age, sex, total cholesterol, mean arterial pressure, heart rate, ischemic cardiomyopathy, percutaneous transluminal coronary angioplasty and diabetes) and conventional echocardiographic parameters (left ventricular (LV) ejection fraction, LV mass index, left atrial volume index, deceleration time, E/e', E-velocity, E/A ratio and tricuspid annular plane systolic excursion). No other echocardiographic parameters remained an independent predictors after adjusting. Furthermore, endocardial, epicardial and whole wall GLS had the highest C-statistics of all the echocardiographic parameters. Conclusion Endocardial, epicardial and whole wall GLS are independent predictors of all-cause mortality in patients with HFrEF. Furthermore, endocardial, epicardial and whole wall GLS were superior prognosticators of all-cause mortality compared with all other echocardiographic parameters. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Herlev and Gentofte Hospital

scholarly journals Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255271
Author(s):  
Petr Lokaj ◽  
Jindrich Spinar ◽  
Lenka Spinarova ◽  
Filip Malek ◽  
Ondrej Ludka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Troponin I ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
Ctni Level

Background The identification of high-risk heart failure (HF) patients makes it possible to intensify their treatment. Our aim was to determine the prognostic value of a newly developed, high-sensitivity troponin I assay (Atellica®, Siemens Healthcare Diagnostics) for patients with HF with reduced ejection fraction (HFrEF; LVEF < 40%) and HF with mid-range EF (HFmrEF) (LVEF 40%–49%). Methods and results A total of 520 patients with HFrEF and HFmrEF were enrolled in this study. Two-year all-cause mortality, heart transplantation, and/or left ventricular assist device implantation were defined as the primary endpoints (EP). A logistic regression analysis was used for the identification of predictors and development of multivariable models. The EP occurred in 14% of the patients, and these patients had higher NT-proBNP (1,950 vs. 518 ng/l; p < 0.001) and hs-cTnI (34 vs. 17 ng/l, p < 0.001) levels. C-statistics demonstrated that the optimal cut-off value for the hs-cTnI level was 17 ng/l (AUC 0.658, p < 0.001). Described by the AUC, the discriminatory power of the multivariable model (NYHA > II, NT-proBNP, hs-cTnI and urea) was 0.823 (p < 0.001). Including heart failure hospitalization as the component of the combined secondary endpoint leads to a diminished predictive power of increased hs-cTnI. Conclusion hs-cTnI levels ≥ 17 ng/l represent an independent increased risk of an adverse prognosis for patients with HFrEF and HFmrEF. Determining a patient’s hs-cTnI level adds prognostic value to NT-proBNP and clinical parameters.

scholarly journals Prognostic Value of Galectin-3 in Patients with Heart Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ivica Bošnjak ◽  
Kristina Selthofer-Relatić ◽  
Aleksandar Včev
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Disease Modifying Drugs ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Galectin 3 ◽  
Myocardial Remodelling ◽  
Lectin Family ◽  
Disease Modifying

Galectins are a family of solubleβ-galactoside-binding lectins that have important role in inflammation, immunity, and cancer. Galectin-3 as a part of this lectin family plays a very important role in development of heart failure. According to recent papers, galectin-3 plasma level correlates with heart failure outcome, primarily with rehospitalisation and death from heart failure. This paper summarizes the most recent advances in galectin-3 research, with the accent on the role of galectin-3 in pathophysiology of myocardial remodelling and heart failure development—with preserved and reduced ejection fraction, and some implication on development of new disease modifying drugs.

scholarly journals The role of galectin-3 in the diagnosis and control of the effectiveness of pharmacotherapy of chronic heart failure

2017 ◽  
Vol 8 (4) ◽  
pp. 5-10
Author(s):  
K. A Giamdzhian ◽  
V. G Kukes
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Initial Level ◽  
Heart Association ◽  
Left Ventricular ◽  
Functional Class ◽  
Clinical Value ◽  
Reduced Ejection Fraction ◽  
Galectin 3

Relevance. At present, it is urgent to develop new biomarkers that can serve as a tool for early diagnosis of the disease in order to select pharmacotherapy and further monitor its effectiveness. The goal is to evaluate the clinical value of the definition of galectin-3 in patients with chronic heart failure (CHF). Materials and methods. The study included 53 patients (31 women, 22 men) with CHF II-III functional class (FC) of the New York Heart Association (NYHA). The mean age of the patients was 71 years (95% confidence interval 68.99-74.37). A group of patients with NYHA FCh II CHF made up 14 people, a group of patients with NYHA-39 CHF III FC. The median of the initial level of the N-terminal brain natriuretic peptide (NT-proBNP) was 65.7 pmol/L, the median of the initial level of galectin-3 - 8.37 pmol/l. Results. The relationship of increased level of galectin-3 with reduced ejection fraction,% (r=-0.26, p=0.04), increased creatinine level (r=0.26, p=0.04) and increased level of NT-proBNP plasma (r=0.3, p=0.02). With other clinical indicators, such as systolic and diastolic blood pressure, heart rate, body mass index, 6-minute walk test, left ventricular mass index, glucose level, total cholesterol, glomerular filtration rate, no statistically significant association was found. A moderate correlation was obtained between the levels of NT-proBNP and galectin-3 plasma (r=0.3, p=0.02). Reduction in the level of galectin-3 after the treatment was detected in 84.3% of patients. The conclusion. Galectin-3 can serve as an additional diagnostic biomarker of CHF.

scholarly journals Prognostic of NT-proBNP in heart failure patients with preserved, mid and reduced ejection fraction

2021 ◽  
Vol 5 (3) ◽  
pp. 5-12
Author(s):  
Reynie Leonel Reinoso Gonella ◽  
Yasmín Céspedes Batista ◽  
Anthony Gutiérrez ◽  
Lisnaldy Ramírez Osoria ◽  
Helio Manuel Grullón Rodríguez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Ejection Fraction ◽  
Plasma Levels ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).

P5406Impact of the albumin level on the prognostic value of diuretic response in patients admitted for acute decompensated heart failure: a prospective study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Yamamoto ◽  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
S Tamaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Albumin Level ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diuretic Response ◽  
Cox Analysis ◽  
The Impact

Abstract Background The reduced diuretic response (DR) has been shown to be associated with poor clinical outcome in patients with acute decompensated heart failure (ADHF). In addition, hypoalbuminemia, which is related to DR, has been also reported to predict poor prognosis in ADHF patients. However, there is no information available on the impact of albumin level on the prognostic value of DR in patients with ADHF. Methods We prospectively studied 296 consecutive patients who were admitted for ADHF and survived to discharge. The patients were divided into 2 groups according to the presence or absence of hypoalbuminemia at the admission, defined as the serum level of albumin at admission <3.5g/dl, and DR was defined as weight loss per 40mg intravenous dose and 80mg oral dose of furosemide up to day 4. The endpoint was a composite of all-cause mortality and unplanned hospitalization for worsening heart failure. Results There were 144 patients with hypoalbuminemia and 152 patients without hypoalbuminemia. During a mean follow-up period of 2.2±1.5 years, 88 patients with hypoalbuminemia and 53 patients without hypoalbuminemia reached the endpoint. In group with hypoalbuminemia, DR was significantly smaller in patients with than without the endpoint (0.85 [0.50–1.50] vs 1.60 [0.76–2.70] kg/40mg furosemide, p=0.003), while there was no significant difference in DR between them in group without hypoalbuminemia (1.17 [0.59–1.66] vs 1.07 [0.75–1.88] kg/40mg furosemide, p=0.381). At multivariate Cox analysis, in group with hypoalbuminemia, DR was significantly associated with the endpoint, independently of age, left ventricular ejection fraction, and serum creatinine and plasma BNP levels. On the other hand, in group without hypoalbuminemia, DR showed no significant association with the endpoint at univariate Cox analysis. Kaplan-Meier analysis showed that patients with poor DR (≤1.08 kg/40mg furosemide: median value) had a significantly higher risk of the endpoint in group with hypoalbuminemia, but not in group without hypoalbuminemia (Figure). Figure 1 Conclusion Our results suggested that prognostic value of DR in ADHF patients is affected by the presence or absence of hypoalbuminemia.

scholarly journals The diagnostic and prognostic value of galectin‐3 in patients at risk for heart failure with preserved ejection fraction: results from the DIAST‐CHF study

2021 ◽  
Vol 8 (2) ◽  
pp. 829-841
Author(s):  
Tobias Daniel Trippel ◽  
Meinhard Mende ◽  
Hans‐Dirk Düngen ◽  
Djawid Hashemi ◽  
Johannes Petutschnigg ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Preserved Ejection Fraction ◽  
Galectin 3 ◽  
Patients At Risk ◽  
Diagnostic And Prognostic Value
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