Galectin 3 – an ace up your sleeve in identifying acute cardiac dyspnea

Introduction: The wide spectrum of pathologies that may clinically express through acute dyspnea, requires rapid triage and a specific therapeutic approach in life-threatening situations. Cardiac dyspnea is misdiagno-sed in about 15-20% of cases due to atypical manifes-tations, associated diuretic therapy and/or overlapped pathologies (mainly of respiratory origin). Objective methods, such as the determination of serum cardiac biomarkers (widely recognized or of recent use), sig-nificantly reduce decision-making times and allow for early therapy.
Objective: To perform a comparative analysis between NT-proBNP (N-terminal prohormone brain natriure-tic peptides) and galectin 3 in terms of their diagnostic value in the identification of acute cardiac dyspnea.
Methods: The prospective study included 208 patients evaluated for dyspnea of acute onset (de novo or ex-acerbation of a chronic dyspnea). The serum levels of NT-proBNP and galectin 3 were measured upon ad-mission. Patients were divided according to etiological criteria into two subgroups: cardiac and non-cardiac. The Pearson correlation coefficient was used to establi-sh the relationship between the variables. Diagnostic accuracy of the two biomarkers was assessed by ROC curve analysis both on the total study group and for par-ticular subsets of patients (renal failure, age >60 years, left ventricular ejection fraction, LVEF <40%, obesity, diabetes mellitus, supraventricular rhythm disorders – atrial fibrillation/flutter, arterial hypertension).
Results: The mean age of the patients was 72.96±11.11 years and 61.1% of them had a cardiac cause of dyspnea. The study showed a correlation between NT-proBNP and galectin-3 that is direct, moderate to strong (r=0.477) and significant (p=0.000). According to the ROC analysis, the predictive diagnostic value of cardiac dyspnea is similar between NT-proBNP (area under curves, AUC=0.781, p=0.000) and galectin 3 (AUC=0.803, p=0.000) on the total patient population. In addition, summation of the two components into a single latent variable was associated with an increase in AUC providing a superior diagnostic accuracy compa-red to the independent analysis of the two biomarkers. Conclusions: T he use of galectin 3 and NT-proBNP in combination facilitates, in emergency settings, the rapid triage of patients presenting with acute dyspnea, with significant practical implications for the prompt initiation of specific therapy and stratification of car-diovascular risk.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)