Galectin-3 as a Diagnostic Biomarker in Patients with Chronic stable Heart Failure

Abstract

Heart failure (HF) is a progressive clinical syndrome resulting from various cardiac disorders. Galectin-3 promotes adverse cardiac remodeling leading to chronic heart failure (CHF). Currently, brain natriuretic peptide (BNP) and N-terminal pro BNP (NT-pro BNP) are widely used as diagnostic biomarker for heart failure (HF) and cardiac dysfunction in clinical medicine. This study aimed to measure the level of Galectin-3 as a diagnostic biomarker in patients with chronic heart failure (CHF) and controls to determine the association between galectin-3 levels with NT-pro BNP levels, age, gender, and left ventricular ejection fraction (LVEF).  A case-control study was carried out from April 2022 to August 2022. A total of 60 patients with chronic heart failure (CHF) (patient group) and 60 subjects with normal ejection fractions (control group) confirmed by echocardiography were enrolled in Ibn Al-Bitar Specialized Center for cardiac surgery, Baghdad, Iraq. Enzyme-linked immunosorbent assay technique (ELISA) assessed serum NT-pro BNP and Galectin-3 levels.  The median serum level of NT pro BNP in patients was 627.85 pg/ml (range= 366.89-4000 pg/ml) which was much higher than that controls (median = 262.63 pg/ml, range= 155.42-359.52 pg/ml) with highly significant differences. The mean serum level of Galectin-3 in patients with CHF was 8.96±1.75 ng/ml which was higher than that of controls (5.45±1.28 ng/ml) with a highly significant difference. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NT-pro BNP and Galectin-3 in discrimination between patients  with CHF and controls for NT-pro BNP, the area under the curve (AUC) was 1.0, 95%CI= 1.0-1.0, p <0.001. The sensitivity and specificity of the test at cut off value of NT-pro BNP= 363.21 pg/ml was 100% for both. For Galectin-3, the AUC was 0.944, 95%CI= 0.906-0.982, p <0.024. The sensitivity and specificity of the test at cut off value of Galectin-3 = 6.5 ng/ml was 93% and 85%, respectively. Galectin-3 with higher sensitivity and AUC can be used as a valuable biomarker for the diagnosis of CHF. Simultaneous testing of both Galectin-3 and NT-pro BNP can further improve the detection of patients with CHF.