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Ahead of print
Original Article
Submitted: 2022-02-01
Accepted: 2022-05-06
Published online: 2022-08-11
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The prognostic role of galectin-3 and endothelial function in patients with heart failure

Vasiliki Tsigkou12, Gerasimos Siasos123, Evangelos Oikonomou12, Marina Zaromitidou1, Konstantinos Mourouzis1, Stathis Dimitropoulos1, Evanthia Bletsa12, Nikolaos Gouliopoulos1, Panagiota K. Stampouloglou12, Maria-Evi Panoilia12, Georgios Marinos1, Konstantinos Tsioufis1, Manolis Vavuranakis12, Dimitris Tousoulis1
DOI: 10.5603/CJ.a2022.0074
·
Pubmed: 35975796
Affiliations
  1. Department of Cardiology, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
  2. Department of Cardiology, ‘Sotiria’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
  3. Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States

open access

Ahead of print
Original articles
Submitted: 2022-02-01
Accepted: 2022-05-06
Published online: 2022-08-11

Abstract

Background: Heart failure (HF) is nowadays classified as HF with reduced ejection fraction (HFrEF), HF with mildly reduced EF (HFmrEF), and HF with preserved EF (HFpEF). Endothelial dysfunction (assessed by flow-mediated dilatation [FMD]), increased arterial stiffness (assessed by carotid-femoral pulse-wave velocity [PWV]), and galectin-3, a biomarker of myocardial fibrosis, have been linked to major adverse cardiovascular events (MACE) in patients with ischemic HF.

Methods: In this study we prospectively enrolled 340 patients with stable ischemic HF. We assessed the brachial artery FMD, carotid-femoral PWV, and galectin-3 levels, and patients were followed up for MACE according to EF group.

Results: Interestingly, the FMD values exhibited a stepwise improvement according to left ventricular ejection fraction (LVEF) (HFrEF: 4.74 ± 2.35% vs. HFmrEF: 4.97 ± 2.81% vs. HFpEF: 5.94 ± 3.46%, p = 0.01), which remained significant after the evaluation of possible confounders including age, sex, cardiovascular risk factors, and number of significantly stenosed epicardial coronary arteries (b coefficient: 0.990, 95% confidence interval: 0.166–1.814, p = 0.019). Single-vessel coronary artery disease (CAD) was more frequent in the group of HFpEF (HFrEF: 56% vs. HFmrEF: 64% vs. HFpEF: 73%, p = 0.049). PWV did not display any association with LVEF. Patients who presented MACE exhibited worse FMD values (4.51 ± 2.35% vs. 5.32 ± 2.67%, p = 0.02), and the highest tertile of galectin-3 was linked to more MACEs (36% vs. 5.9%, p = 0.01).

Conclusions: Flow-mediated dilatation displayed a linear improvement with LVEF in patients with ischemic HF. Deteriorated values are associated with MACE. Higher levels of galectin-3 might be used for risk stratification of patients with ischemic HF.

Abstract

Background: Heart failure (HF) is nowadays classified as HF with reduced ejection fraction (HFrEF), HF with mildly reduced EF (HFmrEF), and HF with preserved EF (HFpEF). Endothelial dysfunction (assessed by flow-mediated dilatation [FMD]), increased arterial stiffness (assessed by carotid-femoral pulse-wave velocity [PWV]), and galectin-3, a biomarker of myocardial fibrosis, have been linked to major adverse cardiovascular events (MACE) in patients with ischemic HF.

Methods: In this study we prospectively enrolled 340 patients with stable ischemic HF. We assessed the brachial artery FMD, carotid-femoral PWV, and galectin-3 levels, and patients were followed up for MACE according to EF group.

Results: Interestingly, the FMD values exhibited a stepwise improvement according to left ventricular ejection fraction (LVEF) (HFrEF: 4.74 ± 2.35% vs. HFmrEF: 4.97 ± 2.81% vs. HFpEF: 5.94 ± 3.46%, p = 0.01), which remained significant after the evaluation of possible confounders including age, sex, cardiovascular risk factors, and number of significantly stenosed epicardial coronary arteries (b coefficient: 0.990, 95% confidence interval: 0.166–1.814, p = 0.019). Single-vessel coronary artery disease (CAD) was more frequent in the group of HFpEF (HFrEF: 56% vs. HFmrEF: 64% vs. HFpEF: 73%, p = 0.049). PWV did not display any association with LVEF. Patients who presented MACE exhibited worse FMD values (4.51 ± 2.35% vs. 5.32 ± 2.67%, p = 0.02), and the highest tertile of galectin-3 was linked to more MACEs (36% vs. 5.9%, p = 0.01).

Conclusions: Flow-mediated dilatation displayed a linear improvement with LVEF in patients with ischemic HF. Deteriorated values are associated with MACE. Higher levels of galectin-3 might be used for risk stratification of patients with ischemic HF.

Full Text:

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Keywords

heart failure, galectin-3, endothelial function, prognosis, ejection fraction

Supp./Additional Files (4)
Supplementary Figure Legend
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Supplementary Figure 1: Box-plots/Stacked bars of incidence of MACE according to LVEF, age, FMD and tertiles of galectin-3
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Supplementary Figure 2: ROC curve of the prognostic capability of LVEF category, FMD and galectin-3 (highest tertile) for MACE
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Supplementary Figure 3: ROC curve of the prognostic capability of LVEF category, FMD and galectin-3 (highest tertile) for the combined end point of rehospitalization for HF and/or death
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386KB
About this article
Title

The prognostic role of galectin-3 and endothelial function in patients with heart failure

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2022-08-11

Page views

947

Article views/downloads

358

DOI

10.5603/CJ.a2022.0074

Pubmed

35975796

Keywords

heart failure
galectin-3
endothelial function
prognosis
ejection fraction

Authors

Vasiliki Tsigkou
Gerasimos Siasos
Evangelos Oikonomou
Marina Zaromitidou
Konstantinos Mourouzis
Stathis Dimitropoulos
Evanthia Bletsa
Nikolaos Gouliopoulos
Panagiota K. Stampouloglou
Maria-Evi Panoilia
Georgios Marinos
Konstantinos Tsioufis
Manolis Vavuranakis
Dimitris Tousoulis

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