title: Additional value of Galectin-3 to BNP in acute heart failure patients with preserved ejection fraction.
abstract: BACKGROUND
  Almost half of patients with acute heart failure have preserved ejection fraction (HFpEF). HFpEF is a diagnostic challenge using traditional investigation tools; Galectin-3 (Gal-3) is an emerging biomarker useful in individuals at risk for HF. The aim of our study is to analyse the relation and prognostic value of Gal-3, BNP and renal dysfunction in patients with HFpEF compared to patients with reduced ejection fraction (HFrEF).
  
  
  METHODS
  We enrolled 98 patients with acute heart failure (AHF) and measured Gal-3, BNP, and estimated glomerular filtration rate (eGFR) within 12h of hospital admission. On the basis of echocardiographic findings we divided our sample into two groups: patients with HFrHF (ejection fraction<50%) or HFpEF (ejection fraction>50%). Patients were followed up at 6months.
  
  
  RESULTS
  No differences in Gal-3 levels were found in the two subgroups (HFrEF: 19.5±5.1ng/mL; HFpEF: 20.5±8.7, p=0.56). Gal-3 was inversely related to renal dysfunction (LogGal-3 vs eGFR: r=-0.30, p=0.01) but did not correlate with LogBNP levels (r=0.07, p=0.55). Gal-3 was associated with more advanced diastolic dysfunction in HFpEF (p=0.009). In addition LogGal-3 was related to diastolic LV stiffness (all patients: r=0.45, p<0.001; HFpEF: r=0.64, p<0.001). Cox regression analysis showed that LogGal-3>1.30 was related to poor outcome independently from renal dysfunction and other risk factors only in HFpEF (univariate HR 23.98 [3.03-89.45]; p<0.001). Adjusted for renal dysfunction (HR 16.32 [1.98-34.09]; p=0.009).
  
  
  CONCLUSIONS
  Gal-3 is not able to distinguish between HFrEF and HFpEF patients. However it is related to diastolic dysfunction severity and LV stiffness in HFpEF. Gal-3 demonstrates a prognostic role independently from renal dysfunction in subjects with HFpEF.
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Beltrami
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Ruocco
authors.affiliation: NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, UK.
authors.forename: Amardeep Ghosh
authors.initials: AG
authors.lastname: Dastidar
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Franci
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lucani
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Aloia
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
authors.forename: Ranuccio
authors.initials: R
authors.lastname: Nuti
authors.affiliation: Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy. Electronic address: palazzuoli2@unisi.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Palazzuoli
mesh_terms: D000368:Aged; D001798:Blood Proteins; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013318:Stroke Volume
chemical_list: D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D020097:Natriuretic Peptide, Brain
keywords: Diastolic function; Galectin-3; HFpEF; Outcome; Renal dysfunction