测试ID：GAL3
Galectin-3, Serum

Aiding in the prognosis for patients diagnosed with heart failure

Risk-stratification of heart failure patients

早期的治疗失败和治疗靶标的迹象

心力衰竭是一种复杂的心血管疾病，就患者的临床表现而言，具有多种病因和异质性。人口老龄化的患病率显着增加，并且与高短期和长期死亡率有关。在急诊室诊断和治疗的患者中，超过80％的患者在即将到来的一年内被重新入院，这会导致昂贵的治疗和疗法。

The development and progression of heart failure is a clinically silent process until manifestation of the disorder, which typically occurs late and irreversibly into its progression. Mechanistically, heart failure, whether due to systolic or diastolic dysfunction, is thought to progress primarily through adverse cardiac remodeling and fibrosis in response to cardiac injury and/or stress. Galectin-3 is a biomarker that appears to be actively involved in both the inflammatory and some fibrotic pathways.

Galectin-3是一种碳水化合物结合凝集素，其表达与包括巨噬细胞，中性粒细胞和肥大细胞在内的炎症细胞有关。Galectin-3与心血管生理过程有关，包括肌纤维细胞增殖，组织修复和心力衰竭的心脏重塑。Galectin-3的浓度已用于预测各种心脏侮辱后的不良重塑。

<24 months: not established

2-17 years: < or =25.0 ng/mL

>或= 18年：

在临床上，Galectin-3浓度可以分为3种风险类别，这是由几项大型慢性心力衰竭研究的结果证实的：

17.9-25.9 ng/ml（中级风险）

>25.9 ng/mL (higher risk)

Results should be interpreted in the context of the individual patient presentation. Elevated galectin-3 results indicate an increased risk for adverse outcomes and signal the presence of galectin-3-mediated fibrosis and adverse remodeling. Once galectin-3 concentrations are elevated they are relatively stable over time in the absence of intervention.

Knowledge of a heart failure patient's galectin-3 results may assist in risk stratification and lead to more aggressive management. There are no specific galectin-3 inhibitors available at this time and heart failure patients with elevated galectin-3 concentrations should be treated and monitored according to established guidelines. Angiotensin receptor blockers (ARBs) and aldosterone antagonists are thought to be particularly effective.

A large multicenter, prospective, observational study was conducted to derive the reference intervals for galectin-3 that included 1,092 subjects between the ages of 55 and 80 years without any known cardiac disease (520 males, 572 females). The 97.5th percentile of galectin-3 in that cohort was 22.1 ng/mL. Individuals with concentrations greater than 22.1 ng/mL had a significant association with mortality and New York Heart Association (NYHA) classification. However, this was an older population and definitive evidence of cardiac disease was not documented.

Galectin-3 has not been shown to be useful in the acute diagnosis of heart failure, and natriuretic peptides (BNP or NT-proBNP) should be utilized for this purpose.

溶血已被证明会干扰乳肠蛋白3的细胞内释放引起的lectectin-3测定法。明显溶血的标本将被拒绝。

杂抗抗体，特别是人血清中的人抗抗体抗体，可能会导致lectectin-3结果升高。杂毒素抗体可能与试剂免疫球蛋白反应，并随后干扰体外免疫测定。常规接触动物或动物血清产品的患者可能会容易受到这种干扰，并且可以观察到异常的高值或低值。

Patients with high concentrations of rheumatoid factor, as well as other autoimmune disorders, may also yield falsely elevated results and should be interpreted with caution.

1. Van der Velde AR, Meijers WC, Van den Heuvel ER, et al: Determinants of temporal changes in galectin-3 level in the general population: Data of PREVEND. Int J Cardiol 2016;222:385-390. doi: 10.1016/j.ijcard.2016.07.241

2. Mueller T, Gegenhuber A, Leitner I, et al: Diagnostic and prognostic accuracy of galectin-3 and soluble ST2 for acute heart failure. Clin Chim Acta 2016;463:158-164. doi: 10.1016/j.cca.2016.10.034

3. Sudharshan S, Novak E, Hock K, et al: Use of biomarkers to predict readmission for congestive heart failure. Am J Cardiol 2017;119:445-451. doi: 10.1016/j.amjcard.2016.10.022

4. Meijers WC, van der Velde AR, Muller Kobold AC, et al: Variability of biomarkers in patients with chronic heart failure and healthy controls. Eur J Heart Fail 2017;19:357-365. doi: 10.1002/ejhf.669

5. Meeusen JW，Johnson JN，Gray A等：无心力衰竭的儿科患者可溶性ST2和Galectin-3。Clin Biochem 2015; Dec; 48（18）：1337-1340。doi：10.1016/j.clinbiochem.2015.08.007