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Galectin 3: association to neurohumoral activity, echocardiographic parameters and renal function in outpatients with
Freja Stoltze Gaborit1,2, Helle Bosselmann3,4, Caroline Kistorp5,6
1Department of Cardiology, Herlev University Hospital, Herlev, Denmark. freja.stoltze.gaborit@regionh.dk.
Insights
Galectin 3 (Gal-3) is linked to reduced kidney function and elevated cardiac biomarkers in heart failure patients. It does not reflect myocardial function but indicates increased neurohumoral activity and impaired renal function.
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- Galectin 3 (Gal-3) is implicated in cardiac and renal fibrosis.
- Previous studies suggest Gal-3 as a potential cardio-renal biomarker.
- The simultaneous evaluation of Gal-3 with cardiac and renal function markers in heart failure (HF) is lacking.
Purpose of the Study:
- To assess the relationship between plasma Galectin 3 (Gal-3) concentrations and neurohumoral activity, myocardial function, and renal function in patients with HF.
- To investigate Gal-3's association with advanced echocardiographic measures and 24-h urinary albumin excretion.
Main Methods:
- Prospective enrollment of 132 HF patients with reduced left ventricular ejection fraction (LVEF).
- Measurement of plasma Galectin 3 (Gal-3) concentrations.
- Assessment of echocardiographic parameters, neurohumoral markers (NT-proBNP, proANP, chromogranin A, Copeptin), estimated glomerular filtration rate (eGFR), and urinary albumin excretion.
Main Results:
- Higher Gal-3 levels correlated with significantly lower eGFR, independent of other factors.
- Gal-3 was not associated with urinary albumin excretion or echocardiographic measures of myocardial function (LVEF, LV mass index, etc.).
- Plasma Gal-3 concentrations showed significant associations with increased levels of NT-proBNP, proANP, chromogranin A, and Copeptin.
Conclusions:
- Elevated plasma Gal-3 levels in HF patients are associated with reduced renal function (eGFR) and heightened neurohumoral activity.
- Gal-3 does not appear to reflect myocardial function in systolic HF based on echocardiographic parameters.
- Gal-3 may serve as a biomarker for cardio-renal interactions, reflecting both renal impairment and neurohormonal dysregulation in HF.
Background:
Galectin 3 (Gal-3) reflects cardiac fibrosis in heart failure HF, but has also been associated to renal fibrosis and impaired renal function. Previous research has suggested that Gal-3 could be a cardio-renal biomarker, but it has never been tested simultaneous in a single study whether Gal-3 reflects echocardiographic measures, neurohumoral activity and renal function. The aim of this study was to evaluate the relationship between plasma concentrations of Gal-3 and neurohumoral activity, myocardial and renal function in patients with HF, including advanced echocardiographic measures and 24-h urinary albumin excretion (albuminuria).
Methods:
We prospectively enrolled 132 patients with reduced left ventricular ejection fraction (LVEF) referred to an outpatient HF clinic. The patients had a median age of 70 years (interquartile rage: 64-75), 26.5 % were female, median LVEF was 33 % (27-39 %) and 30 % were in NYHA class III-IV.
Results:
Patients with plasma concentrations of Gal-3 above the median had significantly lower estimated glomerular filtration rate (eGFR) and this association remained significant in multivariate regression analysis (β: -0.010; 95 % CI -0.012--0.008; P < 0.001), adjusted for age, gender, medical treatment. Plasma concentrations of Gal-3 were not associated with albuminuria (Beta: 0.008; 95 % CI:-0.028-0.045; P = 0.652). There were no association between plasma concentrations of Gal-3 and myocardial function or structure estimated by LVEF, LVmassIndex, LVIDd, E/é or LV global longitudinal strain (P > 0.05 for all). In multivariate analyses plasma concentrations of Gal-3 were significantly associated with the cardiac biomarkers: NT-proBNP (β: 0.047; 95 % CI: 0.008-0.086; P = 0.020), proANP (β: 0.137; 95 % CI: 0.067-0.207; P < 0.001), chromogranin A (β: 0.123; 95 % CI: 0.052-0.194; P < 0.001) and Copeptin (β: 0.080; 95 % CI: 0.000-0.160; P = 0.049). Multivariate analysis was adjusted for eGFR, age, gender and medical treatment.
Conclusions:
Increased plasma concentrations of Gal-3 are associated with reduced eGFR and increased plasma concentrations of NT-proBNP, proANP, chromogranin A and Copeptin, but not with echocardiographic parameters reflecting myocardial function. These results suggest that Gal-3 reflects both increased neurohumoral activity and reduced eGFR, but not myocardial function in patients with systolic HF.
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