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Prognostic Value of Galectin-3 for Adverse Outcomes in Chronic Heart Failure
Benjamin French1, Le Wang2, Bonnie Ky3
1Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Galectin-3 shows prognostic value in heart failure, especially for patients with preserved ejection fraction. This fibrosis marker helps predict adverse events and mortality over time.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Management
Background:
- Galectin-3, a fibrosis marker, has suggested prognostic value in chronic heart failure.
- Its specific role compared to established biomarkers remains uncertain.
Purpose of the Study:
- To evaluate the prognostic value of galectin-3 in heart failure patients.
- To compare galectin-3's accuracy against established biomarkers like ST2, troponin I, and BNP.
Main Methods:
- Analysis of the Penn Heart Failure Study cohort (1385 participants).
- Cox regression models to assess galectin-3's association with adverse events.
- Receiver operating characteristic curves to compare prognostic accuracy at 1 and 5 years.
Main Results:
- Higher galectin-3 levels correlated with increased risk of adverse events (HR 1.96; P < .001).
- This association was strongest in patients with preserved ejection fraction (HR 3.30; P < .001).
- At 5 years, galectin-3 was the most accurate risk discriminator for preserved ejection fraction patients.
Conclusions:
- Galectin-3 demonstrates significant prognostic value for long-term outcomes in heart failure patients.
- It is particularly valuable for risk stratification in patients with preserved ejection fraction.
Background:
Clinical studies have suggested the prognostic value of galectin-3, a marker of fibrosis, in chronic heart failure. However, the specific role of galectin-3, compared with established biomarkers, remains uncertain.
Methods And Results:
The Penn Heart Failure Study was an ambulatory heart failure cohort that included 1385 participants with reduced (1141), preserved (106), and recovered (138) left ventricular ejection fraction (LVEF). Cox regression models determined the association between galectin-3 and risk of all-cause mortality, cardiac transplantation, or placement of a ventricular assist device. Receiver operating characteristic curves compared the prognostic accuracy of galectin-3, high-sensitivity soluble Toll-like receptor 2 (ST2), troponin I, and B-type natriuretic peptide (BNP) at 1 and 5 years. Higher galectin-3 levels were associated with an increased risk of adverse events (adjusted hazard ratio of 1.96 for each doubling in galectin-3; P < .001). This association was most pronounced among participants with preserved LVEF (adjusted hazard ratio 3.30; P < .001). At 5 years, galectin-3 was the most accurate discriminator of risk among participants with preserved LVEF (area under the curve 0.782; P = .81 vs high-sensitivity ST2; P = .029 vs troponin I; P = .35 vs BNP). BNP was most accurate among participants with reduced and recovered LVEF (areas under the curves 0.716 and 0.728, respectively).
Conclusions:
Galectin-3 could have prognostic value for long-term events among patients with heart failure and preserved ejection fraction.
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