Abstract
Objective : to determine the diagnostic value of galectin-3 in transplant recipients with myocardial fibrosis and acute heart transplant rejection, verified by endomyocardial biopsy. Materials and methods . The study included 124 patients with end-stage heart failure. Their ages ranged from 16 to 71 (average 48 ± 12) years, of which 106 (85%) were men and 18 (15%) were women. From 2013 to 2016, these patients underwent a heart transplant procedure at the Shumakov National Medical Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation. Analysis of endomyocardial biopsy specimens was used to verify acute cellular, humoral rejection and myocardial fibrosis of the heart transplant. Severity and nature of fibrosis was evaluated using a qualitative imaging technique. Galectin-3 concentration was measured by enzyme immunoassay using Human Galectin-3 Platinum ELISA reagent kits (Bender MedSystems GmbH, Vienna, Austria). Results . In the long-term post-transplantation period, in comparison with the early post-transplantation period, the number of verified graft myocardial fibrosis increased by 88% in recipients who had acute rejection crises and by 37% in recipients who had no rejection crises. Graft myocardial fibrosis was detected more often in recipients who had acute humoral rejection than in those who had acute cell rejection (92% vs 75% of cases, respectively). Plasma galectin-3 levels in recipients with graft myocardial fibrosis was higher than in recipients without it (p = 0.05 1 year and p = 0.01 1–5 years after heart transplantation). In recipients who had acute rejection crises, the risk of developing graft myocardial fibrosis was 1.64 (RR = 1.64 ± 0.1 [95% CI 1.1–2.2]). Conclusion . Galectin-3 is a biomarker for myocardial fibrosis in acute heart transplant rejection.
Highlights
Objective: to determine the diagnostic value of galectin-3 in transplant recipients with myocardial fibrosis and acute heart transplant rejection, verified by endomyocardial biopsy
Galectin-3 concentration was measured by enzyme immunoassay using Human Galectin-3 Platinum ELISA reagent kits (Bender MedSystems GmbH, Vienna, Austria)
In the long-term post-transplantation period, in comparison with the early post-transplantation period, the number of verified graft myocardial fibrosis increased by 88% in recipients who had acute rejection crises and by 37% in recipients who had no rejection crises
Summary
Diagnostic value of galectin-3 in heart transplant recipients with myocardial complications. Objective: to determine the diagnostic value of galectin-3 in transplant recipients with myocardial fibrosis and acute heart transplant rejection, verified by endomyocardial biopsy. В отдаленные сроки после транспланта‐ ции у реципиентов сердца возрастает риск развития субклинической хронической сердечной недоста‐ точности, возникающей вследствие совокупности различных патологических факторов, приводящих к формированию фиброза миокарда трансплантата, таких как артериальная гипертензия, острое оттор‐ жение и васкулопатия трансплантата, другие забо‐ левания [1]. К числу относительно недавно описанных биомаркеров развития сердечной недостаточности и фиброза миокарда относится галектин‐3, принад лежащий к семейству лектинов и играющий важ‐ ную роль в регуляции процессов пролиферации миофибробластов, иммунного ответа, воспаления и ремоделирования сосудов сердца [4, 5]. У реципиентов сердца роль галектина‐3 изучена в меньшей степени, том XXII No 1–2020 однако установлено, что его уровень в плазме крови выше у пациентов с фиброзом миокарда трансплан‐ тата [7]. Целью настоящего исследования явилось определение диагностической эффективности галек‐ тина‐3 у реципиентов с фиброзом миокарда и острым отторжением трансплантата, верифицированными при эндомиокардиальной биопсии
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