DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF). Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM) type 2 is not well-studied.

Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.

Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction) and DM type 2. The patients were divided into two groups according to the left ventricle (LV) ejection fraction (EF): a group with CHF and preserved ejection fraction (PEF) (EF≥50%) and with CHF and reduced ejection fraction (EF<50%). Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP) and galeсtin-3 were measured.

Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007). In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01). A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05), while in the group with PEF, the correlation was not significant (p=0.225). In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05).

Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

1. Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 2014;63(12):1123-33.

2. Qiu-Sheng YIN, Bing SHI, Lan D, Lei BI. Comparative study of galectin-3 and B-type natriuretic peptide as biomarkers for the diagnosis of heart failure. Journal of Geriatric Cardiology 2014;11:79-82.

3. Belenkov N, Mareev VY, Ageev FT, Danielian MO. The first results of a national epidemiological study – epidemiological study of patients with chronic heart failure in clinical practice (for uptake) – AGEO-CHF. Serdechnaya Nedostatochnost' 2003; 4 (3): 116-21. Russian (Беленков Ю. Н., Мареев В. Ю., Агеев Ф. Т., Даниелян М. О. Первые результаты национального эпидемиологического ис-следования – эпидемиологическое обследование больных ХСН в реальной клинической прак-тике (по обращаемости) – ЭПОХА–О–ХСН. Сердечная Недостаточность 2003;4(3):116 21).

4. Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 2011;13:18-28.

5. The Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. Increasing awareness and improving the management of heart failure in Europe: the IMPROVEMENT of HF initiative. Eur J Heart Fail 1999;1(2):139 44.

6. Castaсo Rodrнguez S, Coma-Canella I, Lуpez Salazar B, Barba Cosials J. Echocardiographic findings and NT-proBNP level in type-2 diabetic patients with and without ischemic heart disease. Rev Esp Cardiol 2009;62:1184-8.

7. Shen WF. An intriguing association between congestive heart failure and diabetes mellitus. Chin Med J 2010;123:643-5.

8. Von Bibra H, St John Sutton M. Impact of diabetes on post infarction heart failure and left ventricular remodeling. Curr Heart Fail 2011;8:242-251.

9. Peng Q1, Hu W, Su H et al. Levels of B-type natriuretic peptide in chronic heart failure patients with and without diabetes mellitus. Exp Ther Med 2013;5:229-232.

10. Nakahara S, Oka N, Wang Y, et al. Characterization of the nuclear import pathways of Galectin-3. Cancer Res 2006;66:9995-10006.

11. Chen K, Jiang RJ, Wang CQ, et al. Predictive value of plasma galectin-3 in patients with chronic heart failure. Eur Rev Med Pharmacol Sci 2013;17(8):1005-11.

12. National guidelines for the diagnosis and treatment of chronic heart failure (4th revision). Serdechnaya Nedostatochnost' 2013; 81 (7): 379-472. Russian (Национальные рекомендации по ди-агностике и лечению хронической сердечной недостаточности (четвертый пересмотр). Сердечная Недостаточность 2013;81(7):379–472).

13. de Boer RA, Lok DJ, Jaarsma T, et al. Predictive value of plasma galectin-3 levels in heart failure with reduced and preserved ejection fraction. Ann Med 2011;43:60-68.

14. van Kimmenade RR, Januzzi JL Jr, Ellinor PT, et al. Utility of amino-terminal probrain natriuretic peptide, galectin-3, and apelin for the evaluation of patients with acute heart failure. J Am Coll Cardiol 2006;48:1217-24.

15. McKelvie RS, Komajda M, McMurray J, et al. Baseline plasma NT-proBNP and clinical characteristics:results from the irbesartan in heart failure with preserved ejection fraction trial. J Card Fail 2010;16(2):128-34.

16. van den Hurk K, Alssema M, Kamp O, et al. Slightly elevated B-type natriuretic peptide levels in a nonheart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study. Eur J Heart Fail 2010;12:958-65.

17. Lund LH, Donal E, Oger E, et al.; on behalf of the KaRen Investigators. Association between cardiovascular vs. non-cardiovascular co-morbidities and outcomes in heart failure with preserved ejection fraction. Eur J Heart Fail 2014;16(9):992-1001.

18. Magnusson M, Jovinge S, Shahgaldi K, et al. Brain natriuretic peptide is related to diastolic dysfunction whereas urinary albumin excretion rate is related to left ventricular mass in asymptomatic type 2 diabetes patients. Cardiovasc Diabetol 2010; 9:2.

19. Shah RV, Chen-Tournoux AA, Picard MH, et al. Galectin-3, cardiac structure and function, and longterm mortality in patients with acutely decompen¬sated heart failure. Eur J Heart Fail 2010;12:826-32.

20. Smiseth OA, Tendera M. Diastolic heart failure. London: Springer-Verlag; 2008.

21. Albertini JP, Cohen R, Valensi P, et al. B-type natriuretic peptide, a marker of asymptomatic left ventricular dysfunction in type 2. Diabetes Metab 2008;34(4 Pt 1): 355-62.

22. Dencker M, Stagmo M, Dorkhan M. Relationship between natriuretic peptides and echocardiography parameters in patients with poorly regulated type 2 diabetes. Vascular Health and Risk Management 2010;6:373-82.

23. GörmüşU1, Ozmen D, Ozmen B, et al. Serum N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and homocysteine levels in type 2 diabetic patients with asymptomatic left ventricular diastolic dysfunction. Diabetes Res Clin Pract 2010;87:51-6.

24. Kiencke S, Handschin R, von Dahlen R, et al. Pre-clinical diabetic cardiomyopathy: prevalence, screening, and outcome. Eur J Heart Fail 2010;12:951-7.

25. Kim JY, Lee EY, Jee JH, et al. N-terminal pro-brain natriuretic peptide (NT-proBNP) in Type 2 diabetes with left ventricular dysfunction. Diabetes Res ClinPract 2007;77(Suppl 1):238-42.

26. Valle R, Bagolin E, Canali C, et al. The BNP assay does not identify mild left ventricular diastolic dysfunction in asymptomatic diabetic patients. Eur J Echocardiogr 2006;7:40-4.