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Introdução: A Hipertensão Arterial é uma das patologias mais prevalentes a nível
mundial. Fruto desta patologia surgem adaptações estruturais e funcionais no coração que
levam à Hipertrofia Ventricular Esquerda e à Insuficiência Cardíaca, mostrando-se também
um fator de risco para doenças cardiovasculares e morte súbita. Em consequência,
entendemos que se afigura importante o reconhecimento de doentes com Hipertrofia
Ventricular Esquerda e com controlo inadequado de pressão arterial, prevenindo-se assim
o aparecimento de resultados irreversíveis. A Galectina 3, na qualidade de biomarcador
analítico, tem sido estudada como possível opção para rastreio destes doentes, uma vez que,
apresenta uma função reguladora na remodelação cardíaca.
Objetivos: O objetivo desta dissertação consiste na realização de um estudo observacional
analisando a relação entre o valor de Galectina 3, a existência de Hipertrofia Ventricular
Esquerda e o controlo de pressão arterial, e avaliar a possibilidade de utilização da Galectina
3 como biomarcador no seguimento dos doentes hipertensos.
Método: Consulta de documentação e recolha de informação clínica de doentes seguidos
na Consulta de Hipertensão Arterial no Centro Hospital Universitário Cova da Beira,
nomeadamente o seu controlo da pressão arterial, o valor analítico do biomarcador
Galectina 3, a existência de Hipertrofia Ventricular Esquerda, dados demográficos tais
como sexo, idade, raça e condição socioeconómica e, a presença de Lesões Órgão Alvo da
Hipertensão Arterial tais como Enfarte Agudo do Miocárdio, Insuficiência Cardíaca,
Acidente Vascular Cerebral - diferenciando entre Isquémico ou Hemorrágico -, Acidente
Isquémico Transitório ou Doença Renal Crónica.
Resultados: Dos 48 doentes integrantes neste estudo constatou-se que: 91,7% da amostra
apresentava Galectina 3 acima do cutoff de 11,43 ng/mL; 85,4 % tinha a sua pressão arterial
controlada; 35,4% apresentava Lesões Órgão Alvo e; 40,9% mostrava sinais
ecocardiográficos de Hipertrofia Ventricular Esquerda. No que diz respeito à relação da
Galectina 3 com as variáveis estudadas não foi encontrada nenhuma associação
significativa, não obstante, há algumas tendências que revelam interesse nesta amostra.
Verifica-se que todos os casos de doentes sem controlo de pressão arterial ostentam valores
de Galectina 3 acima do cutoff de 11,43 ng/mL; 94,4% dos doentes com hipertrofia
ventricular esquerda têm Galectina 3 acima do cutoff e; 94,1% dos pacientes com lesões
órgão alvo apresentavam Galectina 3 acima do cutoff de 11,43 ng/mL. Conclusão: Para a nossa amostra de doentes a Galectina 3 mostrou-se aumentada nos
doentes que de facto tinham a pressão arterial não controlada, que já apresentavam Lesões
Órgão Alvo e Hipertrofia Ventricular Esquerda. Mas como dos resultados da análise não
proveio uma associação significativa estatisticamente entre as referidas variáveis, uma vez
que a Galectina 3 também se apresentava, em percentagens relevantes, acima do valor de
cutoff de 11,43 ng/mL nos doentes que tinham controlo da pressão arterial, nos doentes que
não apresentavam Lesões Órgão Alvo e ainda nos doentes que não apresentavam sinais de
Hipertrofia Ventricular Esquerda, não podemos afirmar que este biomarcador pode ser
utilizado nem para o rastreio da Hipertrofia Ventricular Esquerda, nem para o rastreio de
Lesões Órgão Alvo e de controlo de pressão arterial. Apenas podemos afirmar
perentoriamente que se mantém em aberto a possibilidade de a Galectina 3 ser um
biomarcador de progressão da Hipertensão Arterial.
Introduction: Arterial Hypertension is one of the most prevalent diseases worldwide. As a result of this pathology, structural and functional adaptations emerge in the heart that lead to left ventricular hypertrophy and heart failure, also proving to be a risk factor for cardiovascular diseases and sudden death. As a result, we believe that it is important to recognize patients with Left Ventricular Hypertrophy and with inadequate blood pressure control, thus preventing the appearance of irreversible outcomes. Galectin 3, as an analytical biomarker, has been studied as a possible option for screening these patients, since it has a regulatory function in cardiac remodeling. Objective: The objective of this dissertation is to carry out an observational study analyzing the relationship between the Galectin 3 value, the existence of Left Ventricular Hypertrophy and blood pressure control, and to evaluate the possibility of using Galectin 3 as a biomarker in the follow-up of hypertensive patients. Method: Consultation of documentation and collection of clinical information from patients who were followed at the Arterial Hypertension Consultation at Centro Hospitalar Universitário Cova da Beira, namely their blood pressure control, the analytical value of the biomarker Galectin 3, the existence of Left Ventricular Hypertrophy, demographic data such as sex, age, race and socioeconomic condition, and the presence of Target Organ Injuries of Hypertension such as Acute Myocardial Infarction, Heart Failure, Stroke - differentiating between Ischemic or Hemorrhagic -, Transient Ischemic Accident or Chronic Kidney Disease. Results: Of the 48 patients participating in this study, it was found that: 91.7% of the sample had Galectin 3 above the cutoff of 11.43 ng/mL; 85.4% had their blood pressure controlled; 35.4% had Target Organ Injuries and; 40.9% showed echocardiographic signs of Left Ventricular Hypertrophy. Between the relationship of Galectin 3 with the studied variables, no significant association was found, however, there are some trends that reveal interest in this sample. It was found that all cases of patients with blood pressure uncontrolled have Galectin 3 values above the cutoff of 11.43 ng/mL; 94.4% of patients with Left Ventricular Hypertrophy had Galectin 3 above the cutoff and; 94.1% of patients with Target Organ Injuries had Galectin 3 above the cutoff of 11.43 ng/mL. Conclusion: For our sample of patients, Galectin 3 was shown to be increased in patients who in fact had uncontrolled blood pressure, who already had Target Organ Injuries and had Left Ventricular Hypertrophy. However, as the results of the analysis did not provide a statistically significant association between these variables, since Galectin 3 was also present, in relevant percentages, above the cutoff value of 11.43 ng/mL in patients who had arterial pressure controlled, in patients who did not have Target Organ Injuries and even in patients who did not show signs of Left Ventricular Hypertrophy, we cannot say that this biomarker can be used neither for Left Ventricular Hypertrophy screening, nor for Target Organ Injuries screening and arterial pressure control. We can only affirm that the possibility of Galectin 3 being a biomarker of progression of Arterial Hypertension remains open.
Introduction: Arterial Hypertension is one of the most prevalent diseases worldwide. As a result of this pathology, structural and functional adaptations emerge in the heart that lead to left ventricular hypertrophy and heart failure, also proving to be a risk factor for cardiovascular diseases and sudden death. As a result, we believe that it is important to recognize patients with Left Ventricular Hypertrophy and with inadequate blood pressure control, thus preventing the appearance of irreversible outcomes. Galectin 3, as an analytical biomarker, has been studied as a possible option for screening these patients, since it has a regulatory function in cardiac remodeling. Objective: The objective of this dissertation is to carry out an observational study analyzing the relationship between the Galectin 3 value, the existence of Left Ventricular Hypertrophy and blood pressure control, and to evaluate the possibility of using Galectin 3 as a biomarker in the follow-up of hypertensive patients. Method: Consultation of documentation and collection of clinical information from patients who were followed at the Arterial Hypertension Consultation at Centro Hospitalar Universitário Cova da Beira, namely their blood pressure control, the analytical value of the biomarker Galectin 3, the existence of Left Ventricular Hypertrophy, demographic data such as sex, age, race and socioeconomic condition, and the presence of Target Organ Injuries of Hypertension such as Acute Myocardial Infarction, Heart Failure, Stroke - differentiating between Ischemic or Hemorrhagic -, Transient Ischemic Accident or Chronic Kidney Disease. Results: Of the 48 patients participating in this study, it was found that: 91.7% of the sample had Galectin 3 above the cutoff of 11.43 ng/mL; 85.4% had their blood pressure controlled; 35.4% had Target Organ Injuries and; 40.9% showed echocardiographic signs of Left Ventricular Hypertrophy. Between the relationship of Galectin 3 with the studied variables, no significant association was found, however, there are some trends that reveal interest in this sample. It was found that all cases of patients with blood pressure uncontrolled have Galectin 3 values above the cutoff of 11.43 ng/mL; 94.4% of patients with Left Ventricular Hypertrophy had Galectin 3 above the cutoff and; 94.1% of patients with Target Organ Injuries had Galectin 3 above the cutoff of 11.43 ng/mL. Conclusion: For our sample of patients, Galectin 3 was shown to be increased in patients who in fact had uncontrolled blood pressure, who already had Target Organ Injuries and had Left Ventricular Hypertrophy. However, as the results of the analysis did not provide a statistically significant association between these variables, since Galectin 3 was also present, in relevant percentages, above the cutoff value of 11.43 ng/mL in patients who had arterial pressure controlled, in patients who did not have Target Organ Injuries and even in patients who did not show signs of Left Ventricular Hypertrophy, we cannot say that this biomarker can be used neither for Left Ventricular Hypertrophy screening, nor for Target Organ Injuries screening and arterial pressure control. We can only affirm that the possibility of Galectin 3 being a biomarker of progression of Arterial Hypertension remains open.
Description
Keywords
Galectina 3 Hipertensão Arterial Hipertrofia Ventricular Esquerda Lesões Órgão Alvo