Value of Galectin-3 assay in children with heart failure secondary to congenital heart diseases: a prospective study

Abstract

Background 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. Methods This 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. Results Galectin-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). Conclusions Galectin-3 assay is a promising marker for early diagnosis of HF in children with CHD; but it has no role in detecting HF mortality.

Modification of Serum Galectin-3 and Reversal of Cardiac Remodeling Following Pediatric Transcatheter Atrial Septal Defect Closure

“…Few studies have demonstrated the relationship of Gal-3 concentration and congenital heart disease in children. A recent study demonstrated that Gal-3 is a promising cardiac marker for early diagnosis of heart failure in children with congenital heart disease [37]. Moreover, a higher Gal-3 concentration in children with heart failure with normal or reduced ejection fraction compared with healthy controls was observed, whereas Gal-3 concentration was slightly higher in those with a normal ejection fraction [11].…”

A Scoping Review of Galectin-3 as a Biomarker of Cardiovascular Diseases in Pediatric Populations

“…In the studies conducted in pediatric patients with congenital heart diseases, galectin-3 plasma concentration was significantly higher in children presenting with heart failure signs and symptoms than in those without [ 19 , 20 , 21 , 22 ]. Moreover, galectin-3 levels correlated positively with the severity of circulatory system insufficiency expressed using the Ross Heart Failure Scale, and was lower in children treated with oral spironolactone than in those without [ 19 , 21 ].…”

“…In the studies conducted in pediatric patients with congenital heart diseases, galectin-3 plasma concentration was significantly higher in children presenting with heart failure signs and symptoms than in those without [ 19 , 20 , 21 , 22 ]. Moreover, galectin-3 levels correlated positively with the severity of circulatory system insufficiency expressed using the Ross Heart Failure Scale, and was lower in children treated with oral spironolactone than in those without [ 19 , 21 ]. The evidence of correlation between galectin-3 plasma concentration and chosen echocardiographic parameters of left ventricular function, both systolic and diastolic, exists in the literature and was presented in the studies of Kotby et al and Saleh et al [ 19 , 21 ].…”

“…Moreover, galectin-3 levels correlated positively with the severity of circulatory system insufficiency expressed using the Ross Heart Failure Scale, and was lower in children treated with oral spironolactone than in those without [ 19 , 21 ]. The evidence of correlation between galectin-3 plasma concentration and chosen echocardiographic parameters of left ventricular function, both systolic and diastolic, exists in the literature and was presented in the studies of Kotby et al and Saleh et al [ 19 , 21 ]. In those studies, significant positive correlations between serum galectin-3 levels and left ventricular echocardiographic parameters—such as diastolic and systolic diameter, end-diastolic volume—as well as pulsed wave and tissue doppler measurements—such as mitral E and A wave velocity and myocardial E I and A I velocity—were found.…”

“…The published studies in children revealed that galectin-3 is elevated in diseases which are connected with volume overload and is thus related to the clinical signs. The results clearly presented the differences of the concentrations of this biomarker in children presenting varying degrees of heart failure symptoms—from the asymptomatic to patients presenting symptoms at rest—as correlated by the Ross Heart Failure Classes [ 19 , 21 ]. Moreover, its relationship with the hemodynamical parameters is clear.…”