AKUT PULMONER EMBOLİ HASTALARINDA GALECTİN-3 Galectin-3 in Patients with Acute Pulmonary Embolism

OZET Amac: Pulmoner emboli (PE) goreceli olarak yaygin bir kardiyovaskuler acil durumdur ve spesifik olmayan klinik tablo nedeniyle gozden kacirilabilecek zor bir tanidir. PE patogenezi iyi tanimlanmis olmasina ragmen, PE teshisine yardimci olabilecek klinik bir biyobelirteclere ihtiyac vardir. Teorik olarak, Galectin-3'un (Gal-3) prokoagulan etkisinden dolayi, PE patogenezinde rol alabilecegi dusunulebilir. Bu calismanin amaci, akut PE hastalarinda Gal-3 duzeyinin onemini gostermek ve PE'nin ekokardiyografik ozellikleri ile iliskisini tanimlamaktir. Yontem: 2013 - 2014 tarihleri arasinda ardisik 40 PE hastasi (26 kadin, ort. Yas 60.93 ± 14.28 yil) ve 40 yas uyumlu saglikli kontrol calismaya dahil edildi. Gal-3, D-dimer ve Troponin I duzeyleri olculdu. PE ve kontrol grubundaki tum hastalara transtorasik ekokardiyografik inceleme yapildi. Bulgular: Gal-3 ve D-dimer duzeyleri PE' li hastalarda kontrollere gore anlamli derecede yuksek bulundu. (17.04 ± 6.6 ve 8.22 ± 4.9, p <0.001) Gal-3 seviyeleri, D- dimer (r = 0.595, p <0.001) ve Troponin I degerleri (r = 0.452, p <0.001) ile anlamli bir korelasyon gosterdi. Gal-3 seviyeleri ekokardiyografik parametrelerle anlamli korelasyon gosterdi. ROC egrisi analizinde, %82.5 duyarlilik ve %82.7 ozgulluk ile akut PE tanisi icin gereken seviye 11.43 ng / ml idi. Egri altindaki alan % 95 CI 0.79-0.96 (p <0.001) ile 0.88 idi. Sonuc: Bu calismada akut PE' li hastalarda Gal-3'un rolu gosterilmistir. Gal-3, akut PE' yi teshis etmek icin kullanilabilecek biyobelirtecler arasinda yer alabilir. Ancak daha kapsamli calismalara ihtiyac vardir. Anahtar Kelimeler: Galectin-3; D-dimer; Akut pulmoner emboli; Biyomarker; Ekokardiyografi ABSTRACT Background: Pulmonary embolism (PE) is a relatively common cardiovascular emergency and it is a difficult diagnosis that may be missed because of non-specific clinical presentation. Although the pathogenesis of PE has been well described, there is a clinical need for biomarkers that can aid the diagnosis of PE. Theoretically, because of the procoagulant effect of Galectin-3 (Gal-3), this marker may play a role in the pathogenesis of PE. The aim of the present study is to show the significance of the level of Gal-3 in patients with acute PE and identify a relation to the echocardiographic features of PE. Methods: Between 2013-2014, 40 consecutive PE patients (26 females, mean age 60.93±14.28 years) and 40 age-matched healthy controls were included in this study. Gal-3, D-dimer, and Troponin I were measured. All patients with PE and control subjects underwent transthoracic echocardiographic examination. Results: Gal-3 and D-dimer levels were significantly higher in patients with PE when compared with controls (17.04±6.6 vs 8.22±4.9, p<0.001). Gal-3 levels showed a significant correlation with D-dimer (r=0.595, p<0.001) and Troponin I values (r=0.452, p<0.001). Gal-3 levels showed significant correlation with echocardiographic parameters. In the receiver operating characteristics (ROC) curve analysis, the level required for a diagnosis of acute PE with a sensitivity of 82.5% and specificity of 82.7% was 11.43 ng/ml. The area under the curve was 0.88 with a 95% CI of 0.79-0.96 (p < 0.001). Conclusion: In the present study, we demonstrated the role of Gal-3 in patients with acute PE. Gal-3 can be used to diagnose acute PE. Keywords: Galectin-3; D-dimer; Acute pulmonary embolism; Biomarker; Echocardiography