Cardiology

  • Written by  B De Berardinis, L Magrini, G Zampini, B Zancla, G Salerno, P Cardelli, E Di Stasio, HK Gaggin, A Belcher, BA Parry, JT Nagurney, JL Januzzi Jr and S Di Somma

Risk stratification after acute heart failure based on dual measures of heart fibrosis and fluid overload

Usefulness of combining galectin-3 and BIVA assessments in predicting short- and long-term events in patients admitted for acute heart failure”
B De Berardinis, L Magrini, G Zampini, B Zancla, G Salerno, P Cardelli, E Di Stasio, HK Gaggin, A Belcher, BA Parry, JT Nagurney, JL Januzzi Jr and S Di Somma
BioMed Res Int. 2014; 2014: 983098. doi: 10.1155/2014/983098

In patients with acute heart failure, high serum levels of galectin-3 (a b-galactoside-binding lectin expressed by macrophages and associated with heart fibrosis) are predictive of the need for rehospitalization and the risk of death. The risk of death in these patients is also associated with congestion, which can be measured using bioimpedance vector analysis (BIVA). Researchers in Italy and the United States tested whether the combined use of these two prognostic biomarkers had added value.

This prospective study enrolled 205 patients who presented to hospital emergency departments with acute heart failure. At admission, patients underwent clinical evaluation, blood sampling for galectin-3 determination, and bioimpedance analysis. Follow-up over 18 months considered both rehospitalization and death.

Galectin-3 levels at admission were significantly higher in patients who subsequently died during the 18-month follow-up than in those who survived. Values of reactance normalized to height (Xc/H) were also significantly higher among those who subsequently died, but there was no difference between groups for values of resistance (Rz/H) or phase angle. Statistical analysis suggested that the combination of galectin-3 and BIVA phase angle had better prognostic value than either parameter alone.

The authors concluded that “early assessment of galectin-3 and BIVA seems to be useful in identifying patients at high risk for death and rehospitalization at short and long term. Combining the biomarker and the device could be of great utility since they monitor the severity of two pathophysiological different mechanisms: heart fibrosis and fluid overload.”

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