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Galectin-3 predicts response and outcomes after cardiac resynchronization therapy

Clémentine Andre1, Eric Piver2, Romain Perault3

  • 1Cardiology Department, Trousseau Hospital, University of Tours, 37044, Tours, France. clementine2andre@gmail.com.

Journal of Translational Medicine
|November 5, 2018
PubMed

Insights

Galectin-3 levels can predict how well patients with chronic heart failure respond to cardiac resynchronization therapy (CRT) and their long-term outcomes. Higher galectin-3 levels are associated with a poorer response to CRT.

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.
Abstract

Keywords:
Cardiac resynchronization therapyGalectin-3Heart failure

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