Objective To investigate the diagnostic value and prognosis of Galectin-3, soluble growth stimulation expressed gene 2 protein (sST2) and growth differentiation factor 15 (GDF-15) in heart failure patients with different ejection fractions.
Methods A total of 120 patients with chronic heart failure were selected. According to the left ventricular ejection fraction, the patients with heart failure were divided into three groups: heart failure group with preserved ejection fraction (HFpEF, EF ≥ 50%), heart failure group with intermediate ejection fraction (HFmrEF, 49 ≥ EF ≥ 41), and heart failure group with reduced ejection fraction (HFrEF, EF ≤ 40) ( 40 cases in each group). Thirty-three healthy patients during the same period were selected as the control group. The general clinical data of each group were recorded, and the serum levels of Galectin-3, sST2 and GDF-15 were determined by enzyme-linked immunosorbent assay (ELISA). After 6 months of follow-up, the relevant parameters of patients were statistically analyzed.
Results The differences of the ejection fraction, NT-proBNP, left ventricular end-diastolic diameter, sST2, Galectin-3, GDF-15 and other indicators between control group and heart failure group were statistically significant (P ＜ 0.01). The ejection fraction decreased successively among the control group, reserved group, intermediate group and reduced group (P ＜ 0.01), and the NT-proBNP, left ventricular end-diastolic diameter, sST2, Galectin-3 and GDF-15 increased successively in the control group, reserved heart failure group, intermediate heart failure group and reduced heart failure group (P ＜ 0.01). The results of Spearman correlation analysis showed that the sST2, Galectin-3, GDF-15, NT-proBNP and LVDD in the heart failure group were positively correlated with each other (P ＜ 0.01), and the above five indexes were negatively correlated with ejection fraction (P ＜ 0.01). The results of ROC curve of adverse prognostic events showed that the NT-proBNP index of patients in HFrEF group and HFmrEF group had higher AUC value, sensitivity and specificity, and the GDF-15 index of HFpEF patients had higher AUC value, sensitivity and specificity. The results of multivariate COX regression analysis showed that the sST2 (HR = 0.976, 95%CI = 0.956–0.995), NT-proBNP (HR = 1.000, 95%CI = 1.000–1.001), EF (HR = 1.134, 95%CI = 1.060–1.214) and GDF-15 (HR = 1.004, 95%CI = 1.001–1.008) in different types of chronic heart failure group were the independent predictors of adverse prognostic events in patients with heart failure (P ＜ 0.05 to P ＜ 0.01).
Conclusions The sST2, Galectin-3 and GDF-15 in different types of heart failure groups have high predictive value for the occurrence of adverse events in patients with heart failure. Meanwhile, the sST2, GDF-15 and NT-proBNP can be used as independent risk factors to predict and evaluate short-term risk events in patients.
DownLoad: