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. 2023;30(5):725-733.
doi: 10.5603/CJ.a2022.0074. Epub 2022 Aug 17.

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

Vasiliki Tsigkou  1   2 , Gerasimos Siasos  1   2   3 , Evangelos Oikonomou  4   5 , Marina Zaromitidou  1 , Konstantinos Mourouzis  1 , Stathis Dimitropoulos  1 , Evanthia Bletsa  1   2 , Nikolaos Gouliopoulos  1 , Panagiota K Stampouloglou  1   2 , Maria-Evi Panoilia  1   2 , Georgios Marinos  1 , Konstantinos Tsioufis  1 , Manolis Vavuranakis  1   2 , Dimitris Tousoulis  1
Affiliations

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

Vasiliki Tsigkou et al. Cardiol J. 2023.

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 HF 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 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.

Keywords: ejection fraction; endothelial function; galectin-3; heart failure; prognosis.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Box plots of arterial function parameters (arterial stiffness and endothelial function) according to left ventricular ejection fraction (EF) classification; A. Flow-mediated dilatation (FMD) values according to heart failure (HF) classification; B. Pulse wave velocity (PWV) values according to HF classification. Abbreviations — see Table 1.
See this image and copyright information in PMC

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