The role of galectin-3 marker in the clinical course of chronic heart failure and prediction of the need for palliative medical care performance


DOI: https://dx.doi.org/10.18565/therapy.2024.10.34-42

Shevtsova V.I., Pashkova A.A., Shevtsov A.N., Krasnorutskaya O.N.

N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia
Abstract. Chronic heart failure (CHF) is a common complication of cardiovascular diseases, which is accompanied by changes in body composition of patients. At the same time, changes in the course of the disease depending on body composition are practically not studied. At the terminal stage of the disease, patients may require palliative care (PHC). The level of galectin-3 biomarker progressively increases in patients with obesity (OB) and sarcopenia (SP), playing a role of independent predictor of all-cause mortality or hospitalization due to heart failure.
The aim: to study the level of galectin-3 and CHF clinical course in patients with different body composition while determining their need for PHC.
Material and methods. Body composition and clinical characteristics of the course of the disease were assessed in 298 patients with CHF. Patients were divided into 5 groups depending on body weight and SP presence. Galectin-3 levels were also measured. Using Cox regression, a proportional hazards model for the occurrence of indications for PHC was obtained.
Results and discussion. In the group of patients with sarcopenic obesity, the clinical status assessment scale and 6-minute walk test scores were lower, and the galectin-3 level was higher than in participants with normal weight and muscle strength. According to the results of the Cox regression, the probability of indications for primary health care with an increase in the ratio of muscle mass index to body mass index statistically significantly increased by 22.9 times (p < 0.001), with an increase in the functional class of CHF by 1 – by 1.99 times (p < 0.001), with an increase in the galectin-3 level by 1 – by 1.02 times (p = 0.002), with a decrease in the Barthel index – by 0.96 times (p < 0.001), in the presence of SP – by 3.71 times (p < 0.001). Mutual influence of myopathy, which is characteristic to SP, and CHF leads to worsening of the disease. The increase of galectin-3 level is a sign of this process.
Conclusion. SP, OB and sarcopenic OB are risk factors for an unfavorable prognosis in patients with CHF and an increase of their need for primary medical care.
Keywords: palliative medical care, sarcopenic obesity, body composition, sarcopenia, galectin-3, chronic heart failure
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About the Autors

Veronika I. Shevtsova, MD, PhD (Medicine), associate professor, professor, head of the Department of outpatient therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia. Address: 394036, Voronezh, 10 Studencheskaya St.
E-mail: shevvi@yandex.ru
ORCID: https://orcid.org/0000-0002-1707-436X
Anna A. Pashkova, MD, Dr. Sci. (Medicine), associate professor of the Department of outpatient therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia. Address: 394036, Voronezh, 10 Studencheskaya St.
E-mail: apashkova@vrngmu.ru
ORCID: https://orcid.org/0000-0003-2392-3134
Artem N. Shevtsov, MD, PhD (Medicine), associate professor of the Department of operative surgery with topographic anatomy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia. Address: 394036, Voronezh, 10 Studencheskaya St.
E-mail: shan-87@yandex.ru
ORCID: https://orcid.org/0000-0001-8641-2847
Olga N. Krasnorutskaya, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of outpatient therapy, N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia. Address: 394036, Voronezh, 10 Studencheskaya St.
E-mail: onk@gmail.com
ORCID: https://orcid.org/0000-0003-4796-7334


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