Clin Res Cardiol (2021)
DOI DOI https://doi.org/10.1007/s00392-021-01843-w
Osteopontin and galectin-3 as biomarkers of maladaptive right ventricular remodeling in pulmonary hypertension
S. Keranov1, O. Dörr1, L. Jafari2, C. Liebetrau3, T. Keller3, C. Troidl4, J. Riehm4, W. Rutsatz1, P. Bauer1, S. Kriechbaum5, S. Voß6, M. J. Richter7, K. Tello7, H. Gall7, H. Ghofrani7, S. Guth8, W. Seeger7, C. W. Hamm1, H. Nef1
1Medizinische Klinik I - Kardiologie und Angiologie, Universitätsklinikum Gießen und Marburg GmbH, Gießen; 2Experimentelle Kardiologie, Justus-Liebig-Universität Giessen, Gießen; 3Medizinische Klinik I, Kardiologie, Kerckhoff Klinik GmbH, Bad Nauheim; 4Kardiologie und Angiologie, Justus-Liebig-Universität Giessen, Gießen; 5Abteilung für Kardiologie, Kerckhoff Klinik GmbH, Bad Nauheim; 6Kardiologie / Experimentelle Kardiologie, Kerckhoff Klinik GmbH, Bad Nauheim; 7Medizinische Klinik II - Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Gießen; 8Kerckhoff Klinik GmbH, Bad Nauheim;

Rationale: As there are currently no established diagnostic standards of right ventricular (RV) maladaptation, the diagnosis of maladaptive RV remodeling remains challenging. Biomarkers could further improve risk stratification and prediction of RV maladaptation in pulmonary hypertension (PH).

Objective: This study assessed whether circulating osteopontin (OPN) and galectin-3 (Gal-3) may be utilized as biomarkers of maladaptive right ventricular remodeling (maladaptive RV) and in patients with pulmonary hypertension.

Methods: In this prospective study of 181 patients, we examined plasma levels of OPN and Gal-3 in patients with PH (n=62), patients with dilated cardiomyopathy [left ventricular ejection fraction (LV-EF) <35% and preserved RV function] (DCM, n=34), patients with left ventricular hypertrophy caused by severe aortic stenosis [LV-EF >55% and preserved RV function] (LVH, n=47), and control subjects without LV or RV abnormalities (n=38).

Results: PH patients with maladaptive RV showed higher mean pulmonary artery pressure (PAPmean), pulmonary vascular resistance (PVR), systolic pulmonary artery pressure (PASP), RV end-diastolic basal diameter, and N-terminal pro-brain natriuretic peptide levels as well as lower tricuspid annular plane systolic excursion (TAPSE) than those with adaptive RV (p<0.0001 for all comparisons). Maladaptive RV was defined as TAPSE/PASP <0.26 mm/mmHg. OPN and Gal-3 levels were higher in PH, DCM, and LVH than in the controls (p<0.001 for all comparisons). OPN concentrations in PH patients with maladaptive RV were significantly higher than in those with adaptive RV (P<0.01). Receiver operating characteristics (ROC) analysis identified OPN as a good predictor of maladaptive RV (AUC=0.76, p<0.001). Gal-3 did not differentiate between adaptive and maladaptive RV remodeling in PH. OPN and Gal-3 levels did not correlate with parameters of LV remodeling, and there were no significant differences in OPN and Gal-3 concentrations between patients with PH, DCM, or LVH.

Conclusion: OPN is a potential biomarker of RV maladaptation. Gal-3 levels were not associated with parameters of RV or LV remodeling.
https://dgk.org/kongress_programme/jt2021/aP345.html