Galectin-3 predicts response and outcomes after cardiac resynchronization therapy

Area of Science:

• Cardiology
• Biomarker Research
• Heart Failure Management

Background:

• Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients with wide QRS complexes.
• A significant portion of CRT patients do not respond to treatment.
• Myocardial fibrosis is linked to non-response to CRT.

Purpose of the Study:

• To investigate if galectin-3, a biomarker associated with fibrosis, can predict CRT response.
• To assess galectin-3's ability to predict long-term outcomes in CRT patients.

Main Methods:

• Prospective inclusion of heart failure patients eligible for CRT with left bundle branch block (≥120 ms).
• Measurement of serum galectin-3 levels, Selvester ECG scoring, and cardiac MRI with late gadolinium enhancement (LGE).
• CRT response defined by absence of death/hospitalization and ≥15% reduction in left ventricular end-systolic volume at 6 months.

Main Results:

• 80% of 61 patients (mean age 61±5 years, EF 27±5%) were responders at 6 months.
• Responders showed significantly lower LGE (8±13% vs 22±16%, p=0.006).
• Galectin-3 levels showed a trend towards lower values in responders (16±6 vs 19±8 ng/mL, p=0.13).
• LGE ≥14% and Gal-3 ≥22 ng/mL independently predicted CRT response (OR=0.17, p=0.007 and OR=0.11, p<0.001, respectively).
• Higher Galectin-3 levels predicted adverse long-term outcomes at 48 months (HR=3.31, p=0.05).

Conclusions:

• Serum galectin-3 levels are a significant predictor of CRT response in heart failure patients.
• Galectin-3 also effectively predicts long-term cardiovascular outcomes following CRT implantation.