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Relationship of galectine3 and NTproBNP circulating levels with cardiac hypertrophy and function in patients with sarcomeric hypertrophic cardiomyopathy
Advisor(s)
Abstract(s)
Background and aim: Cardiac fibrosis, a hallmark of sarcomeric hypertrophic cardiomyopathy (sHCM) with
left ventricular hypertrophy (LVH), is a substrate for ventricular arrhythmias and heart failure. NTproBNP
plasma levels in sHCM patients (pts) are associated with LVH, cardiac dysfunction and adverse outcomes.
Galectin3 (Gal3), a biomarker of fibrosis, may be also a marker of severity thus reflecting prognosis. We
tested this hypothesis evaluating both biomarkers in sHCM pts and their association with clinical, morphological
and functional echocardiographic (echo) data.
Methods: Sixty sHCM pts (49.8±16.3y, 52% female) – major echo criteria and positive genotype, nondilated
well contracting left ventricle (LV), stable clinical condition and no diseases that might influence Gal3
levels – were enrolled. ECG, echo study, and complete laboratorial panel were performed. Associations
between circulating Gal3 and NTproBNP levels, and between both biomarkers and imaging data (structural
and functional evaluation by echoDoppler/tissue Doppler imaging), current symptoms, hospitalization due to
sHCM or presence of nonsustained ventricular tachycardia (NSVT) on Holter, were looked for. Statistical
analyses were conducted, first including and then excluding 6 pts under cardiovascular drugs that might influence
Gal3 levels. Associations were considered statistically significant if p<0.05.
Results: No association was found between Gal3 (14.95±9.29ng/ml) and NTproBNP (1207.02±1779.9
pg/ml) levels or between Gal3 and LVH degree, cardiac dimensions or functional echo parameters or indices,
even after adjusting for age and body mass index (BMI). NTproBNP levels were associated with maximal wall
thickness (WT), r=0.58), LVWT score (r=0.40), left atrial dimension (r=0.39), septal E' (r=−0.54), lateral E'
(r=−0.58), septal E/E' (r=0.49), lateral E/E' (r=0.59), and septal S' (r=−0.58), independently of age and BMI.
Higher levels of NTproBNP were found in the presence of symptoms (p<0.001) and hospitalizations due to
sHCM (p=.001). None of the biomarkers was associated with NSVT occurrence. Results were similar after
the exclusion of pts under potentially confounding therapies.
Conclusions: In sHCM pts, NTproBNP but not Gal3 levels are associated with LVH degree, echoindices
of LV function, LV diastolic pressure, symptoms and hospitalization. These findings favor NTproBNP but not
Gal3 as a helpful tool to identify and characterize sHCM pts at a higher risk for cardiac related morbidity.
Description
Copyright © 2016 Oxford University Press
Keywords
Pedagogical Context
Citation
European Heart Journal (2016) 37 (Abstract Supplement), 571-572
Publisher
Oxford University Press