Evaluation of Soluble ST2 and Galectin-3 Levels in Patients with Heart Failure

Objective: Soluble Stromelysin-2 (sST2) and galectin-3 have been found to be associated with prognosis in HF patients. However, there is no study evaluating the clinical importance of sST2 and galectin-3 in HF classification according to ejection fraction (EF). In the present study, we aimed to assess the diagnostic value of sST2 and galectin-3 in HF classification based on EF.
Method: Forty-one HF patients with reduced EF (HFrEF), 41 with mildly-reduced EF (HFmrEF), 41 with preserved EF (HFpEF) and 41 healthy controls were included in the study. EF≤40% was defined as HFrEF, between 41% and 49% as HFmrEF, and ≥50% as HFpEF. The sST2 and galectin-3 of the patients were measured, and comparisons were made.
Results: There were significant differences among groups in terms of sST2 (p< 0.001) and galectin-3 (p= 0.007) levels. Post hoc analysis demonstrated that HFmrEF and HFrEF patients had significantly higher sST2 (p= 0.001 and p= 0.001, respectively) and galectin-3 (p= 0.043 and p= 0.007, respectively) levels than the control group, whereas HFpEF and control group were similar in terms of sST2 and galectin-3 (p= 0.645 and p= 0.436, respectively). In correlation analysis, sST2 and galectin-3 levels were positively correlated with BNP (r=0.240, p= 0.002 and r=0.172, p= 0.028, respectively) whereas negatively correlated with EF (r=-0.403, p< 0.001 and r=-0.295, p< 0.001, respectively).
Conclusion: sST2 and galectin-3 were higher in patients with HFrEF and HFmrEF compared to the control group, and these markers increased further as EF decreased. However, these markers weren’t different between the HFpEF patients and the control group.

Keywords: Galectin-3, heart failure, stromelysin 2