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The impact of diabetes mellitus and microvascular complications on heart failure biomarkers

Session Poster Session 3

Speaker Florina Fringu

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : F Fringu (Cluj Napoca,RO), D Zdrenghea (Cluj Napoca,RO), G Gusetu (Cluj Napoca,RO), B Caloian (Cluj Napoca,RO), H Comsa (Cluj Napoca,RO), A Bian (Cluj Napoca,RO), D Gurzau (Cluj Napoca,RO), R Tomoaia (Cluj Napoca,RO), C Florea (Cluj Napoca,RO), F Morar (Cluj Napoca,RO), D Pop (Cluj Napoca,RO)

F Fringu1 , D Zdrenghea2 , G Gusetu1 , B Caloian1 , H Comsa1 , A Bian2 , D Gurzau1 , R Tomoaia1 , C Florea1 , F Morar2 , D Pop1 , 1University of Medicine and Pharmacy of Cluj Napoca, Rehabilitation Cardiology Department Cluj-Napoca - Cluj Napoca - Romania , 2Clinical Rehabilitaion Hospital, Cardiology Department - Cluj Napoca - Romania ,


Background: The prevalence of heart failure (HF) is increased in diabetic patients. Several studies confirmed the prognostic role of ST2 and Galectin-3 (Gal-3) in HF patients, but the relationship between diabetes mellitus (DM) along with its complications and the new biomarkers is still uncertain.
Methods:  88 subjects with decompensated heart failure (NYHA classes III-IV) were enrolled, with a mean age of 69.82 ± 9.5 years, 61.7% of which were men and 47.9% of them with previous DM. All patients were evaluated both clinically and echocardiographically. The entire cohort had serum concentrations of ST2, Gal-3 and NT-proBNP measured upon admission. Patients with DM were divided into two groups: those with DM microvascular complications (retinopathy, nephropathy or polyneuropathy - 58.9%) or without- 41.1%. 
Results:  Mean left ventricular ejection fraction (LVEF) was 38.84 ± 11.3%,  without significant differences between the two groups (p-NS).
Concerning HF biomarkers, the following mean values were obtained: ST2 - 46.32 ± 25.8 ng/ml, Gal 3-15.19 ± 6.7 ng/ml, NT-pro BNP - 3493.04 ± 3884.8 pg/ml. There were no statistically significant differences between patients with or without DM: ST2 : 47.51 ± 28.7ng/ml  vs 44.89 ± 23.1 ng/ml; Gal-3: 15.25 ± 7.7ng/ml vs 15.07 ± 5.7ng/ml; NT-proBNP: 3857.42 ± 3844.2 pg/ml vs 3104.28 ± 3940.4 pg/ml. 
When comparing the two groups of diabetic subjects, only Gal-3 values were found to be consistently higher in subjects with microvascular complications: 16.23 ± 4.9 ng/ml  vs 13.74 ± 10.4 ng/ml (p=0.005); ST2 : 53.21 ± 31.9ng/ml  vs 39.5 ± 23.3 ng/ml (p-NS); NT-proBNP : 4364.9 ± 4213.9 pg/ml vs 3188.96 ± 3350.0 pg/ml (p=NS).
ST 2 levels correlated significantly with NT-proBNP levels (r=0.24; p=0.03), hypocholesterolemia (r= 0.22; p=0.048) and GFR (r=-0.22) in both groups. There was no direct correlation between ST2 levels and the NYHA class (p=0.334). Gal-3 levels also correlated well with LVEF value (r=0.22; p=0.048), NT-pro BNP levels (r=0.40; p < 0.0001) and NYHA class (p <0.0001). 
Conclusions: Biomarkers of HF used for screening the general population are also useful in patients with DM, with Galectin-3 levels being significantly higher in diabetic patients with microvascular complications than in those without.

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