Osteopontin and galectin-3 predict the risk of ventricular tachycardia and fibrillation in heart failure patients with implantable defibrillators.
BACKGROUND
Myocardial extracellular matrix remodelling provides electrical heterogeneity entailing ventricular tachycardia/fibrillation (VT/VF) in heart failure (HF) patients. Osteopontin (OPN) and Galectin-3 (Gal-3) are fibrosis markers and may reflect the extension of the arrhythmogenic substrate. We assessed whether plasma OPN and Gal-3 predict the risk of sustained VT/VF in a cohort of HF patients with implantable cardioverter-defibrillator (ICD).


METHODS
A total of 75 HF patients underwent pre-ICD implantation clinical evaluation and assessment of plasma OPN and Gal-3. The primary endpoint was the time to the occurrence of the first sustained VT/VF. Hazard ratios (HR) were derived from Cox proportional-hazards analysis.


RESULTS
Patients with coronary artery disease (CAD) had higher plasma OPN (79.8 ± 44.0 ng/mL vs. 66.0 ± 31.8 ng/mL; P = 0.04). Both Gal-3 (r = -0.38; P = 0.01) and OPN (r = -0.27; p = 0.01) were negatively related to estimated glomerular filtration rate. After 29 ± 17 months, 20 patients (27%) reached the primary endpoint. Patients with VT/VF had higher plasma OPN and Gal-3 (97.4 ± 51.7 ng/mL vs. 65.9 ± 31.3 ng/mL; P = 0.002 and 19.7 ± 8.5 ng/mL vs. 16.2 ± 6.2 ng/mL; P = 0.05). In univariate analysis, OPN (log-OPN, HR: 32.4; 95%CI: 3.9-264.7; P = 0.001) and Gal-3 (HR: 1.05; 95%CI: 1.00-1.11; P = 0.04) predicted sustained VT/VF. In multivariable analysis, both OPN (HR: 41.4; 95%CI: 3.8-441.9; P = 0.002) and Gal-3 (HR: 1.06; 95%CI: 1.00-1.12; P = 0.03) retained their prognostic power after correction for age, sex, history of MI, EF, NYHA class, eGFR, use of ACE-I, and amiodarone.


CONCLUSIONS
Plasma OPN and Gal-3 predict sustained VT/VF in HF patients at high risk for SCD. Larger prospective studies should outline the role of these biomarkers in predicting SCD on top of conventional risk stratification.
['Francia|Pietro|P|', 'Adduci|Carmen|C|', 'Semprini|Lorenzo|L|', 'Borro|Marina|M|', 'Ricotta|Agnese|A|', 'Sensini|Isabella|I|', 'Santini|Daria|D|', 'Caprinozzi|Massimo|M|', 'Balla|Cristina|C|', 'Simmaco|Maurizio|M|', 'Volpe|Massimo|M|']
D000368:Aged D015415:Biomarkers D001798:Blood Proteins D017147:Defibrillators, Implantable D005260:Female D005500:Follow-Up Studies D037502:Galectin 3 D037161:Galectins D006333:Heart Failure D006801:Humans D008297:Male D008875:Middle Aged D053495:Osteopontin D011237:Predictive Value of Tests D011446:Prospective Studies D012307:Risk Factors D017180:Tachycardia, Ventricular D014693:Ventricular Fibrillation
osteopontin Galectin-3 heart failure ICD biomarkers sudden death