Galectin-3 in Children with Chronic Heart Failure with Normal and Reduced Ejection Fraction: Relationship to Disease Severity.
Heart failure (HF) progression has not been studied in pediatric patients as well as HF in patients with a normal ejection fraction (HFNEF). We aimed to evaluate galactin-3 in children with HFNEF and reduced ejection fraction (HFREF) and its correlation to disease severity and progression. This cross-sectional study involved 45 chronic HF patients taking G1a (23 HFNEF children) and G1b (22 HFREF children) compared to 45 age- and sex-matched controls (G2) subjected to history taking, Ross functional HF classification, conventional and tissue Doppler echocardiographic systolic and diastolic function assessment (FS%, E/A, Sm, Em/Am, E/Em) and laboratory investigations [glomerular filtration rate, serum galactin-3 level (ELISA)]. The results showed that serum galactin was increased in patients compared to controls (p > 0.001); a cutoff value of 3.5 ng/ml was estimated for HF diagnosis HFNEF patients who had higher galactin-3 levels than HFREF patients, but it did not reach statistical significance (p = 0.194). Galactin-3 levels positively correlated to the Ross HF classification (p = 0.01) and E/Em(p = 0.032) and negatively correlated to FS%, Smand Em/Am(p = 0.028, 0.022, 0.043). Galactin-3 levels were significantly reduced in patients receiving spironolactone (p = 0.049). Galactin-3 can be a tool for chronic HF diagnosis and a marker of disease severity and staging in children with HFNEF and HFREF. The role of spironolactone in reducing galactin-3 in pediatric HF requires further research.
Pediatrics Department, Faculty of Medicine, Children's Hospital, Ain Shams University, 29dar el ezz, medinet el zahraa, helmeyet el zaytoon, Cairo, 11321, Egypt.
Alyaa Amal
AA
Kotby
Pediatrics Department, Faculty of Medicine, Children's Hospital, Ain Shams University, 29dar el ezz, medinet el zahraa, helmeyet el zaytoon, Cairo, 11321, Egypt. ibrahim_omneya@yahoo.com.
Omneya Ibrahim
http://orcid.org/0000-0002-3366-5661
OI
Youssef
Clinical Pathology Department, Children's Hospital, Ain Shams University, Cairo, Egypt.
Mohamed Omar
MO
Elmaraghy
Pediatrics Department, Faculty of Medicine, Children's Hospital, Ain Shams University, 29dar el ezz, medinet el zahraa, helmeyet el zaytoon, Cairo, 11321, Egypt.
Osama Salah
OS
El Sharkawy
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013148:Spironolactone / Q000627:therapeutic use; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology
D015415:Biomarkers; D001798:Blood Proteins; D004232:Diuretics; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D013148:Spironolactone
Children; Galactin-3; Heart failure; Normal ejection fraction