Global Longitudinal Strain of the Systemic Ventricle Is Correlated with Plasma Galectin-3 and Predicts Major Cardiovascular Events in Adult Patients with Congenital Heart Disease

Backround and Objective: We sought to assess in adult congenital heart disease (ACHD) patients the prognostic value of plasma galectin-3 (Gal-3) levels and systemic ventricular global longitudinal strain (SV GLS) as well as their association with NTproBNP and arrhythmogenesis. Materials and Methods: We studied 58 patients (26 men, mean age 37 ± 16.8 years) with various congenital heart diseases. Patients underwent echocardiogram, 24 h ambulatory ECG monitoring, while NTproBNP and Gal-3 were measured. They were followed up (median of 790.5 days -IQR 350.3 days) and major cardiovascular events (MACE) were recorded. Results. Mean Gal-3 levels were 17.07 ± 6.38 ng/m. Plasma Gal-3 was correlated with LogNTproBNP (r = 0.456, p = 0.001).Gal-3 levels associated with supraventricular tachycardia (SVT) (p < 0.001) and ventricular tachycardia (VT) (p < 0.001), but was not associated with MACE (HR 1.018, 95% CI 0.944–1.098, p = 0.641).Mean SVGLS in patients with systemic left ventricle was −15.91% ± 4.09%, which was significantly lower compared to patients with systemic right ventricle and patients with single ventricle (−11.42% ± 3.37% and −11.9% ± 5.06%, respectively, p = 0.021).SV GLS correlated with plasma Gal-3 (r = 0.313, p = 0.027) and logNTproBNP (r = 0.479, p < 0.001). SVGLS correlated with VT arrhythmias (p = 0.004). NTproBNP predicted MACE (AUC 0.750, p = 0.03). SVGLS also predicted MACE (AUC 0.745, p = 0.03. In multivariate analysis, SVGLS and logNTproBNP maintained their predictive value (p = 0.004 and p = 0.009, respectively) Conclusion: In ACHD patients, SV GLS was found to predict MACE independently from NTproBNP and correlated with VT. Gal-3 correlated with NTproBNP and SVGLS as well as SVT and VT, but has not been shown to bear significant prognostic potential.

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Prognostic value of galectin-3 in adults with congenital heart disease

Heart ◽

10.1136/heartjnl-2017-312070 ◽

2017 ◽

Vol 104 (5) ◽

pp. 394-400 ◽

Cited By ~ 9

Author(s):

Vivan J M Baggen ◽

Annemien E van den Bosch ◽

Jannet A Eindhoven ◽

Myrthe E Menting ◽

Maarten Witsenburg ◽

...

Keyword(s):

Heart Failure ◽

Congenital Heart Disease ◽

Heart Disease ◽

Primary Endpoint ◽

Cardiovascular Events ◽

Congenital Heart ◽

Adult Congenital Heart Disease ◽

Nyha Class ◽

Galectin 3 ◽

Cardiac Medication

ObjectiveGalectin-3 is an emerging biomarker for risk stratification in patients with heart failure. This study aims to investigate the release of galectin-3 and its association with cardiovascular events in patients with adult congenital heart disease (ACHD).MethodsIn this prospective cohort study, 602 consecutive patients with ACHD who routinely visited the outpatient clinic were enrolled between 2011 and 2013. Galectin-3 was measured in thaw serum by batch analysis. The association between galectin-3 and a primary endpoint of all-cause mortality, heart failure, hospitalisation, arrhythmia, thromboembolic events and cardiac interventions was investigated using multivariable Cox models. Reference values and reproducibility were established by duplicate galectin-3 measurements in 143 healthy controls.ResultsGalectin-3 was measured in 591 (98%) patients (median age 33 (25–41) years, 58% male, 90% New York Heart Association (NYHA) class I). Median galectin-3 was 12.7 (range 4.2–45.7) ng/mL and was elevated in 7% of patients. Galectin-3 positively correlated with age, cardiac medication use, NYHA class, loss of sinus rhythm, cardiac dysfunction and N-terminal pro-B-type natriuretic peptide (NT-proBNP). During a median follow-up of 4.4 (IQR 3.9–4.8) years, the primary endpoint occurred in 195 patients (33%). Galectin-3 was significantly associated with the primary endpoint in the univariable analysis (HR per twofold higher value 2.05; 95% CI 1.44 to 2.93, p<0.001). This association was negated after adjustment for NT-proBNP (HR 1.04; 95% CI 0.72 to 1.49, p=0.848).ConclusionsGalectin-3 is significantly associated with functional capacity, cardiac function and adverse cardiovascular events in patients with ACHD. Nevertheless, the additive value of galectin-3 to a more conventional risk marker such as NT-proBNP seems to be limited.

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Galectin-3 plasma levels in adult congenital heart disease and the pressure overloaded right ventricle: reason matters

Biomarkers in Medicine ◽

10.2217/bmm-2020-0250 ◽

2020 ◽

Vol 14 (13) ◽

pp. 1197-1205

Author(s):

Ewa Kowalik ◽

Beata Kuśmierczyk-Droszcz ◽

Anna Klisiewicz ◽

Aleksandra Wróbel ◽

Anna Lutyńska ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Adult Congenital Heart Disease ◽

Clinical Status ◽

Pressure Overload ◽

Cross Sectional ◽

Galectin 3 ◽

Congenitally Corrected Transposition ◽

Corrected Transposition

Aim: To assess galectin-3 (Gal-3) levels and their relationship with clinical status and right ventricular (RV) performance in adults with RV pressure overload of various mechanisms due to congenital heart disease. Materials & methods: A cross-sectional study was conducted. Patients underwent clinical examination, blood testing and transthoracic echocardiography. Results: The study included 63 patients with congenitally corrected transposition of the great arteries, 41 patients with Eisenmenger syndrome and 20 healthy controls. Gal-3 concentrations were higher in patients compared with controls (7.83 vs 6.11 ng/ml; p = 0.002). Biomarker levels correlated with age, New York Health Association class, N-terminal probrain natriuretic peptide and RV function only in congenitally corrected transposition of the great arteries patients. Conclusion: Gal-3 profile in congenital heart disease patients and pressure-overloaded RV differs according to the cause of pressure overload.

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Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

BMC Cardiovascular Disorders ◽

10.1186/1471-2261-14-38 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 32

Author(s):

Yu-Sheng Lin ◽

Pi-Hua Liu ◽

Lung-Sheng Wu ◽

Yu-Ming Chen ◽

Chee-Jen Chang ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cardiovascular Events ◽

Congenital Heart ◽

Adult Congenital Heart Disease ◽

Population Based ◽

Major Adverse Cardiovascular Events ◽

Follow Up Study ◽

Adult Congenital

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What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education

Heart ◽

10.1136/hrt.86.1.74 ◽

2001 ◽

Vol 86 (1) ◽

pp. 74-80

Author(s):

P Moons ◽

E De Volder ◽

W Budts ◽

S De Geest ◽

J Elen ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Diseases ◽

Adult Congenital Heart Disease ◽

Tertiary Care ◽

Educational Interventions ◽

Heart Defect ◽

The Impact

OBJECTIVETo assess how much adults with congenital heart disease understand about their heart defect, its treatment, and the preventive measures necessary to avoid complications.DESIGNDescriptive, cross sectional study.SETTINGAdult congenital heart disease programme in one tertiary care centre in Belgium.PATIENTS62 adults with congenital heart disease (47 men; 15 women), median age 23 years.MAIN OUTCOME MEASURESPatients' knowledge was assessed during an outpatient visit using the Leuven knowledge questionnaire for congenital heart diseases, a 33 item instrument developed for this study.RESULTSPatients had adequate knowledge (> 80% correct answers) about their treatment, frequency of follow up, dental practices, occupational choices, appropriateness of oral contraceptives, and the risks of pregnancy. Knowledge about the name and anatomy of the heart defect, the possibility of recurrent episodes of endocarditis during their lifetime, and the appropriateness of different physical activities was moderate (50–80% correct answers). There was poor understanding (< 50% correct answers) about the reasons for follow up, the symptoms of deterioration of the heart disease, the definition, characteristics, and risk factors of endocarditis, the impact of smoking and alcohol on the heart disease, the hereditary nature of the condition, and the suitability of intrauterine devices as contraceptives.CONCLUSIONSAdults with congenital heart disease have important gaps in their knowledge about their condition. The results of this study can be used as a basis for developing or optimising structured educational interventions to enhance patients' health behaviour.

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