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Circulating Galectin-3 Levels Are Persistently Elevated After Heart Transplantation and Are Associated With Renal
Avishay Grupper1, Jose Nativi-Nicolau1, Joseph J Maleszewski2
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Insights
Serum galectin-3 (Gal-3) levels remain elevated after heart transplantation (HTx) and are linked to kidney dysfunction, suggesting a systemic role for Gal-3 beyond cardiac health.
Area of Science:
- Cardiology
- Biomarker Research
- Transplantation Science
Background:
- Galectin-3 (Gal-3) is a biomarker for cardiac remodeling and fibrosis, with elevated levels predicting poor outcomes in heart failure.
- The impact of heart transplantation (HTx) on Gal-3 levels and its prognostic significance post-transplant remain largely unknown.
Purpose of the Study:
- To evaluate changes in serum Gal-3 levels before and after HTx.
- To assess pre-HTx Gal-3 as a predictor of post-HTx outcomes.
- To explore the relationship between Gal-3, cardiac pathology, and renal function.
Main Methods:
- Serum Gal-3 levels were measured in 62 patients pre- and post-HTx.
- Cardiac tissue from endomyocardial biopsies was analyzed for Gal-3 staining, hypertrophy, and fibrosis.
- Correlations between serum Gal-3, tissue markers, and clinical outcomes were examined.
Main Results:
- Serum Gal-3 remained elevated in 56% of patients post-HTx (>17.8 ng/ml).
- A significant inverse correlation was observed between Gal-3 levels and glomerular filtration rate.
- No association was found between serum Gal-3 and myocardial Gal-3 staining, hypertrophy, or fibrosis.
Conclusions:
- This study is the first to show persistent elevated Gal-3 levels in the majority of patients post-HTx.
- Elevated Gal-3 post-HTx is associated with renal dysfunction, indicating a systemic rather than cardiac-specific role.
- Pre-HTx Gal-3 did not significantly predict post-HTx exercise capacity after covariate adjustment.
Objectives:
This study evaluated changes in serum levels of galectin (Gal)-3 before and after heart transplantation (HTx) and assessed the role of pre-HTx Gal-3 as a biomarker for post-HTx outcomes.
Background:
Gal-3 is a novel biomarker that reflects cardiac remodeling and fibrosis. Elevated serum Gal-3 levels are associated with poor prognosis in heart failure patients. Whether Gal-3 levels change following HTx and the significance of post-HTx outcomes are unknown.
Methods:
Serum Gal-3 levels were measured in 62 patients at 118 days (Interquartile Range [IQR]: 23 to 798 days) before and 365 days (IQR: 54 to 767 days) post HTx. Cardiac tissue taken during routine post-HTx endomyocardial biopsy was evaluated to assess the correlation between tissue Gal-3 staining and serum Gal-3 levels and with the presence of myocardial hypertrophy and fibrosis.
Results:
Serum Gal-3 levels remained significantly elevated (>17.8 ng/ml) in 35 patients (56%) post HTx. There was a significant inverse correlation between Gal-3 levels and glomerular filtration rate measured before and after HTx (p > 0.005). There was no association between Gal-3 serum level and Gal-3 staining of myocardial tissue or with the presence of myocyte hypertrophy and interstitial fibrosis post HTx. Elevated pre-HTx Gal-3 levels were associated with reduced post-HTx exercise capacity, but this association was not significant after adjustment for age, body mass index, and glomerular filtration rate.
Conclusions:
This is the first study to demonstrate the fact that Gal-3 levels remain elevated in the majority of patients despite HTx and is associated with renal dysfunction. Our findings suggest Gal-3 is a systemic rather than cardiac-specific biomarker.
