Echocardiographic Indices Compared with Galectin-3 and Pentraxin-3 in Stage C Heart Failure

Background/Objectives: We compared echocardiographic indices with galectin-3 and pentraxin-3 for discriminating established heart failure (HF). Methods: This exploratory cross-sectional secondary analysis included 131 coronary angiography patients: 69 with stage C HF and 62 without an established clinical HF syndrome. Patients with HF were clinically stable without symptoms at rest and were classified as New York Heart Association (NYHA) II or III at study evaluation. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP), the combined mitral Doppler index E/(Em × Sm), right ventricular systolic annular velocity, and both biomarkers were assessed using paired receiver operating characteristic comparisons and clinically adjusted logistic regression. Results: TAPSE/PASP had the highest numerical area under the curve (AUC 0.753; 95% confidence interval 0.671–0.835) and outperformed galectin-3 (AUC 0.500; Holm-adjusted p = 0.0012). Its AUC difference from pentraxin-3 was nonsignificant. E/(Em × Sm) and pentraxin-3 had AUCs of 0.654 and 0.631. TAPSE/PASP retained an association with HF in the joint adjusted model (odds ratio 0.55 per standard deviation; p = 0.0423); E/(Em × Sm) did not. Pentraxin-3 remained associated in its separate adjusted model (odds ratio 1.70; p = 0.0212). NYHA-class and ejection-fraction subgroup differences were nonsignificant after multiplicity correction. Conclusions: TAPSE/PASP discriminated established HF better than galectin-3 in this cohort. The separate pentraxin-3 association warrants further investigation of complementary inflammatory information. These exploratory findings, models, and derived thresholds require independent validation before clinical application.