Galectin-3 is an independent marker for ventricular remodeling and mortality in patients with chronic heart failure
Dirk J Lok1, Sjoukje I Lok, Pieta W Bruggink-André de la Porte
1Deventer Hospital, Nico Bolkesteinlaan 75, 7415 CM, Deventer, The Netherlands. lokd@dz.nl
Insights
Galectin-3 (Gal-3) predicts long-term mortality in severe chronic heart failure (HF) patients. Elevated Gal-3 levels are linked to adverse left ventricular remodeling, indicating its utility as a biomarker.
Area of Science:
- Cardiology
- Biomarker Discovery
- Heart Failure Research
Background:
- Galectin-3 (Gal-3) is a novel marker for myocardial fibrosis.
- Elevated Gal-3 is linked to poor short-term outcomes in heart failure (HF).
- The role of Gal-3 in long-term cardiac remodeling and HF outcomes remains unclear.
Purpose of the Study:
- To assess Galectin-3 (Gal-3) as a biomarker for left ventricular remodeling.
- To evaluate Gal-3's association with long-term mortality in severe chronic HF patients.
Main Methods:
- 240 patients with NYHA Class III/IV HF were followed for 8.7 years.
- Measured circulating Gal-3 and NT-proBNP levels.
- Assessed left ventricular remodeling via serial echocardiography at baseline and 3 months.
Main Results:
- Lower baseline Gal-3 levels correlated with decreased left ventricular end-diastolic volume (LVEDV) over time.
- Gal-3, but not NT-proBNP, significantly predicted long-term mortality (p=0.001).
- Gal-3 levels positively correlated with changes in LVEDV (p=0.007).
Conclusions:
- Galectin-3 is associated with left ventricular remodeling in severe chronic HF.
- Gal-3 serves as a significant predictor of long-term mortality in this patient group.
Background:
Galectin-3 (Gal-3) is a recently discovered marker for myocardial fibrosis and elevated levels are associated with an impaired outcome after short-term follow-up in heart failure (HF) patients. However, whether Gal-3 is related to cardiac remodeling and outcome after long-term follow-up is unknown. Therefore, we determined the utility of Gal-3 as a novel biomarker for left ventricular remodeling and long-term outcome in patients with severe chronic HF.
Methods And Results:
A total of 240 HF patients with New York Heart Association (NYHA) Class III and IV were included. Patients were followed for 8.7 ± 1 years, had a mean age of 71 ± 0.6 years and 73 % of the study population was male. Circulating levels of NT-proBNP and Gal-3 were measured. Serial echocardiography was performed at baseline and at 3 months. At baseline median left ventricular end-diastolic volume (LVEDV) was 267 mL [interquartile range 232-322]. Patients were divided into three groups according to the change in LVEDV. Patients in whom the LVEDV decreased over time had significant lower levels of Gal-3 at entry compared to patients in whom the LVEDV was stable or increased (14.7 vs. 17.9 vs. 19.0 ng/mL; p = 0.004 for trend), whereas no significant differences were seen in levels of NT-proBNP (p = 0.33). Multivariate linear regression analyses revealed that Gal-3 levels were positively correlated to change in LVEDV (p = 0.007). In addition, Gal-3 was a significant predictor of mortality after long-term follow-up (p = 0.001).
Conclusion:
Gal-3 is associated with left ventricular remodeling determined by serial echocardiography and predicts long-term mortality in patients with severe chronic HF.
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