Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment
Abstract
:1. Introduction
2. Results
2.1. Patients’ Characteristics
2.2. Correlates of Plasma Gal-3 Levels
2.3. Prognostic Value of Plasma Gal-3 Levels
3. Discussion
3.1. Relations between Plasma Gal-3 and Renal Function—Mechanisms and Prognostic Implications
3.2. Mechanistic Considerations—Valvular, Myocardial and Vascular Effects of Gal-3 as Potential Contributors to the Prognostic Ability of Pre-procedural Plasma Gal-3 in AS Patients Undergoing BAV
3.3. Mechanistic Considerations—Summary
4. Materials and Methods
4.1. Patients
4.2. Study Protocol
4.3. Statistical Analysis
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
AS | Aortic stenosis |
AVA | Aortic valve area |
BAV | Balloon aortic valvuloplasty |
CKD | Chronic kidney disease |
CI | Confidence interval |
EF | Left ventricular ejection fraction |
eGFR | Estimated glomerular filtration rate |
Gal-3 | Galectin-3 |
HF | Heart failure |
HR | Hazard ratio |
LV | Left ventricular |
NT-proBNP | N-terminal pro-B-type natriuretic peptide |
NYHA | New York Heart Association |
MPG | Mean transvalvular aortic pressure gradient |
SD | Standard deviation |
SEM | Standard error of the mean |
SVR | Surgical aortic valve replacement |
TAVI | Transcatheter aortic valve implantation |
TGF-β | Tumor growth factor-β |
Zva | Valvulo-arterial impedance |
References
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Age, years | 79 ± 8 |
Gender, male | 36 (45%) |
Body mass index, kg/m2 | 26.5 ± 4.1 |
NYHA functional class, II/III/IV | 40/25/15 (50/31/19%) |
eGFR, mL/min per 1.73 m2 | 58 ± 21 |
Hypertension | 71 (89%) |
Diabetes mellitus | 26 (33%) |
Coronary artery disease | 36 (45%) |
NT-proBNP, pg/mL | 2554 (1168–5244) |
AVA, cm2 | 0.7 ± 0.2 |
AVA index, cm2/m2 | 0.4 ± 0.1 |
Maximal transvalvular aortic pressure gradient, mmHg | 84 ± 30 |
Mean transvalvular aortic pressure gradient, mmHg | 52 ± 21 |
LVMI, g/m2 | 174 ± 55 |
EF, % | 52 ± 15 |
Stroke volume index, mL/m2 | 34.0 ± 11.6 |
Systolic blood pressure, mmHg | 129 ± 20 |
Zva, mmHg/(mL/m2) | 5.9 ± 2.3 |
Characteristic | Age | eGFR | NYHA | AVA | MPG | LVMI | EF | Zva |
---|---|---|---|---|---|---|---|---|
Gal-3 | 0.09 0.4 | −0.61 * <0.001 | 0.16 0.2 | 0.01 0.9 | −0.25 0.02 | 0.17 0.14 | −0.12 0.3 | −0.07 0.5 |
NT-proBNP | 0.09 0.4 | −0.37 * 0.001 | 0.20 0.07 | −0.17 0.14 | 0.18 0.11 | 0.40 * <0.001 | −0.26 0.02 | −0.06 0.6 |
Characteristic | Balloon Aortic Valvuloplasty (n = 25) | Other Treatment Modalities (n = 55) | p |
---|---|---|---|
Age, years | 84 ± 6 | 78 ± 8 | <0.001 * |
Gender, male | 11 (44%) | 25 (45%) | 0.9 |
Body-mass index, kg/m2 | 25.3 ± 3.7 | 27.0 ± 4.2 | 0.1 |
NYHA functional class, II/III/IV | 8/8/9 (32/32/36%) | 32/17/6 (58/31/11%) | 0.02 |
Hypertension | 24 (96%) | 47 (85%) | 0.2 |
Diabetes mellitus | 12 (48%) | 14 (25%) | 0.05 |
Coronary artery disease | 14 (56%) | 22 (40%) | 0.2 |
NT-proBNP, pg/mL | 3635 (2349–5755) | 2294 (1004–5055) | 0.14 |
AVA index, cm2/m2 | 0.3 ± 0.1 | 0.4 ± 0.1 | 0.05 |
Maximal transvalvular aortic pressure gradient, mmHg | 83 ± 28 | 84 ± 32 | 0.9 |
Mean transvalvular aortic pressure gradient, mmHg | 52 ± 19 | 52 ± 22 | 0.9 |
LVMI, g/m2 | 183 ± 37 | 170 ± 61 | 0.3 |
EF, % | 48 ± 16 | 53 ± 15 | 0.2 |
Stroke volume index, mL/m2 | 32.2 ± 11.9 | 34.8 ± 11.4 | 0.4 |
Systolic blood pressure, mmHg | 128 ± 22 | 130 ± 19 | 0.7 |
Zva, mmHg/(mL/m2) | 6.4 ± 2.7 | 5.7 ± 2.0 | 0.2 |
Galectin-3 (ng/mL) | 19.0 (13.1–25.2) | 14.5 (11.5–19.5) | 0.06 |
Predictor Variable | β ± SEM | Hazard Ratio (HR) | |
---|---|---|---|
Mean HR (95% CI) | p | ||
Gal-3, unadjusted | |||
Gal-3 (Gal-3 >17.8 vs. <17.8 ng/mL) | 0.71 ± 0.43 | 2.03 (0.88–4.69) | 0.09 |
Gal-3 (per 1-SD increment) | 0.40 ± 0.20 | 1.49 (1.00–2.21) | 0.05 |
Gal-3, adjusted for eGFR | |||
Gal-3 (Gal-3 >17.8 vs. <17.8 ng/mL) | 0.53 ± 0.52 | 1.70 (0.61–4.73) | 0.31 |
Gal-3 (per 1-SD increment) | 0.38 ± 0.29 | 1.46 (0.83–2.57) | 0.19 |
Predictor Variable | β ± SEM | Hazard Ratio (HR) | |
---|---|---|---|
Mean HR (95% CI) | p | ||
Gal-3, unadjusted | |||
Gal-3 (Gal-3 >17.8 vs. <17.8 ng/mL) | 0.84 ± 0.56 | 2.32 (0.78–6.96) | 0.13 |
Gal-3, adjusted for eGFR | |||
Gal-3 (Gal-3 >17.8 vs. <17.8 ng/mL) | 1.19 ± 0.69 | 3.30 (0.86–12.7) | 0.08 |
Gal-3, adjusted for eGFR and Zva | |||
Gal-3 (Gal-3 >17.8 vs. <17.8 ng/mL) | 2.00 ± 0.81 | 7.41 (1.52–36.1) | 0.01 |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Bobrowska, B.; Wieczorek-Surdacka, E.; Kruszelnicka, O.; Chyrchel, B.; Surdacki, A.; Dudek, D. Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment. Int. J. Mol. Sci. 2017, 18, 947. https://doi.org/10.3390/ijms18050947
Bobrowska B, Wieczorek-Surdacka E, Kruszelnicka O, Chyrchel B, Surdacki A, Dudek D. Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment. International Journal of Molecular Sciences. 2017; 18(5):947. https://doi.org/10.3390/ijms18050947
Chicago/Turabian StyleBobrowska, Beata, Ewa Wieczorek-Surdacka, Olga Kruszelnicka, Bernadeta Chyrchel, Andrzej Surdacki, and Dariusz Dudek. 2017. "Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment" International Journal of Molecular Sciences 18, no. 5: 947. https://doi.org/10.3390/ijms18050947