Abstract
Abstract Background The occurrence of HF (heart failure) with preserved ejection fraction (HFpEF) has risen significantly over the past decade. Galectin-3 (Gal-3) and soluble ST2 (sST2) are involved in inflammatory processes and fibrosis and might be useful in estimation of the risk of HFpEF development after myocardial infarction (MI).Purpose: To investigate the association of Gal-3 and sST2, and their follow-up changeswith echocardiographic parameters of systolic and diastolic dysfunctionin patients (pts) with ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods:A prospective, observational study, BIOSTRAT (NCT03735719), enrolled 117 pts. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). Assessedat baseline and at one-year echocardiographic indices included left ventricular ejection fraction (LVEF), atrial and ventricular size, LV posterior wall and septal thickness, LV hypertrophy based on LV mass index, mitral inflow velocities, and early diastolic tissue velocities at the lateral and medial mitral annulus. Results:Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were increased at one-year follow-up (8.5 ng/mL, p < 0.001 and 31.4 ng/mL, p = 0.001, respectively). Fifty of 105 pts (48%) developed HF and 30% of the study population had LVEF <50% at one-year. There were no significant differences between pts with LVEF <50% and ≥50% in terms of baseline, follow-up, nor changes in Gal-3 and sST2 concentrations from baseline to the one-year visit. Gal-3 and sST2 concentrations at baseline, after one-year, and their changes were correlated with echocardiographic parameters. Correlation analysis revealed that higher baseline Gal-3 concentrations correlated inversely only with LV end-diastolic volume at one-year. There were no other significant correlations of baseline, follow-up, nor changes in Gal-3 concentration with echocardiographic parameters. Baseline sST2 values correlated positively with LV end-diastolic diameter, LV end-systolic volume, LV mass index, and inversely with LVEF at one-year, but not with baseline echocardiographic parameters. Changes in sST2 concentration correlated positively only with LVEF at one-year. There were no significant correlations of sST2 concentrations at follow-up with echocardiographic parameters. Only pts with a higher sST2 baseline level had lower LVEF at baseline and after one-year, and pts with higher concentrations of both Gal-3 and sST2 at baseline were more likely to have LV hypertrophy initially and after one-year. There was no clear association of rising biomarkers’ quartiles with other echocardiographic parameters. Conclusions:There was no clear association between both biomarkers and echocardiographic parametersof diastolic dysfunction. Increasing levels of Gal-3 and sST2 do not reflect the HFpEF development in pts after STEMI.
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