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Galectin-3 Is Elevated and Associated With Adverse Outcomes in Patients With Single-Ventricle Fontan Circulation

Alexander R Opotowsky1, Fernando Baraona2, Justin Owumi3

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, MA (A.R.O., M.N.S., A.M.V., F.W., S.C., M.J.L.) Department of Cardiology, Boston Children's Hospital, Boston, MA (A.R.O., J.O., B.L., M.N.S., A.M.V., F.W., M.J.L.).

Journal of the American Heart Association
|January 13, 2016
PubMed

Insights

Elevated galectin-3 levels are common in adults with Fontan circulation and predict a higher risk of hospitalization or death. This finding highlights galectin-3 as a potential biomarker for adverse outcomes in this patient group.

Area of Science:

  • Cardiology
  • Biomarkers
  • Fibrosis

Background:

  • Galectin-3 is implicated in cardiac and noncardiac fibrosis.
  • Elevated galectin-3 predicts adverse outcomes in heart failure patients without congenital heart disease.
  • Adults with single-ventricle Fontan circulation are prone to multiorgan fibrosis and clinical deterioration.

Purpose of the Study:

  • To investigate galectin-3 levels in adults with Fontan circulation.
  • To determine the association between galectin-3 and clinical outcomes in this population.

Main Methods:

  • Plasma galectin-3 concentrations were measured in 70 ambulatory adult Fontan patients and 21 controls.
  • Correlations between galectin-3 and clinical parameters were assessed.
  • Event rates (nonelective hospitalization or death) were analyzed over a median follow-up of 461 days.
  • The risk associated with elevated galectin-3 was evaluated using hazard ratios.

Main Results:

  • Galectin-3 levels were significantly higher in Fontan patients (11.85 ng/mL) compared to controls (9.4 ng/mL).
  • In Fontan patients, galectin-3 correlated positively with age, uric acid, and C-reactive protein, and negatively with estimated glomerular filtration rate.
  • Elevated galectin-3 was associated with a significantly higher risk of nonelective hospitalization or death (HR 6.0, P<0.001), persisting after multivariable adjustment (HR 9.2, P=0.001).

Conclusions:

  • Adults with Fontan circulation exhibit elevated galectin-3 concentrations.
  • Elevated galectin-3 is a significant predictor of increased risk for nonelective cardiovascular hospitalization or death in Fontan patients.
Abstract

Keywords:
Fontan procedureadult congenital heart diseasebiomarkercongenital heart diseasegalectin‐3

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