Abstract
BackgroundGalectin-3 is a new biomarker, which plays an important role in tissue inflammation, cardiac remodeling, and fibrosis. It can be readily measured in the circulation to detect early heart failure (HF). This study aimed to assess the value of galectin-3 assay in early diagnosis of children with heart failure secondary to congenital heart disease (CHD) and correlate it with the patients’ outcome.MethodsThis prospective cohort study included 75 children diagnosed to have CHD; {Group A: 45 CHD children with HF symptoms and reduced ejection fraction (REF) and Group B: 30 CHD children with no HF symptoms and normal ejection fraction (NEF)}. They were compared to 40 age- and sex-matched controls (Group C). Children with CHD undergone history taking, Ross HF classification, Echocardiographic assessment and laboratory investigations including serum galactin-3 level.ResultsGalectin-3 serum level increased in CHD children, and it showed significant increase in (Gp A) compared to Gp B or Gp C (p = ≤ 0.001). In addition, serum level of Galactin-3 was correlated positively with Ross classification (r = 0.68, p = 0.018) and negatively correlated to EF% (r= -0.61, p ≤ 0.001). Galactin-3 showed better diagnostic value than Ross HF classification in early diagnosis of HF in CHD children with a cut point (≥ 10.4), significantly had 96.7% sensitivity, 90% specificity, 91% positive predictive value, 93.2% negative predictive value, with area under the curve (AUC = 0.96) and 93% accuracy. While there was a significant correlation between Ross HF classification and HF outcome in (Gp A) children (p = 0.05), we did not find any significant correlation between serum galectin-3 level and HF mortality in same group (p = 0.08).ConclusionsGalectin-3 assay is a promising marker for early diagnosis of HF in children with CHD; but it has no role in detecting HF mortality.
Highlights
Galectin-3 is a new biomarker, which plays an important role in tissue inflammation, cardiac remodeling, and fibrosis
Three putative routes have been proposed for the development of heart failure (HF) in congenital heart disease (CHD): monogenic entities that cause both CHD and HF; severe CHD lesions in which acquired hemodynamic effects of CHD or surgery result in HF; and, most commonly, a combined effect of complex genetics in overlapping pathways and acquired stressors caused by the primary lesion [3]
According to the number of populations in the locality, the prevalence of children with CHD and the number of patients following-up in the pediatric cardiology clinic, a sample of 75 children known to have CHD was considered. These children were divided into two groups; Group (A) which included 45 children who were subsequently admitted with HF symptoms and reduced ejection fraction (REF) by Echo [24 (53.3%) males and 21 (46.7%) females; age range: 0.6–9.3 years, mean age: 3.7 ± 2.89 years]
Summary
Galectin-3 is a new biomarker, which plays an important role in tissue inflammation, cardiac remodeling, and fibrosis. It can be readily measured in the circulation to detect early heart failure (HF). This study aimed to assess the value of galectin-3 assay in early diagnosis of children with heart failure secondary to congenital heart disease (CHD) and correlate it with the patients’ outcome. Congenital heart diseases (CHD) are abnormalities within the heart’s structure that are present since birth. It is the most common birth defect, approximately affecting 1% of all live born infants [1]. In response to myocardial injury, it freed by cardiac macrophages, provokes fibroblast increase and deposition of collagen in the cardiac muscle by inducing growth factor beta (TGF-b) and exciting matrix production [5, 6]
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