Levels of Galectin-3 in Chronic Heart Failure: A Case-Control Study (original) (raw)
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Galectin-3: A Novel Biomarker of Left Ventricular Remodelling in Chronic Heart Failure
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Heart failure (HF) is a serious condition in which the heart is unable to pump enough blood to meet the demands of the body. The development of HF is often a clinically silent process, with progressive cardiac remodelling eventually leading to symptomatic presentation later in the course of disease progression with high mortality rate. Natriuretic peptides (NPs) help in selecting patients at high risk for future events such as re-hospitalization which only indicate ventricular loading conditions and do not reveal other important mechanisms in HF. The use of novel markers like Galectin-3, could add information about relevant structural changes in the heart, including inflammation, fibrosis, remodelling and a possible guide for treatment. Galectin-3 has been found to be up-regulated in the plasma of patients with acute and chronic heart failure. METHODS 80 subjects of both sexes between 20-80 years diagnosed with chronic heart failure based on Framingham criteria and left ventricular ejection fraction (LVEF) of ≤45% or diastolic dysfunction were selected for the study. Subjects with abnormal renal function were excluded. 80 CHF patients were divided into two groups: (i) CHF with moderate LVD (LVEF >36% and ≤45%) and (ii) CHF with severe LVD (LVEF ≤35%). Serum Galectin-3 levels were compared with BNP, clinical and echocardiographic indices of LV structural remodelling between the two groups. RESULTS Serum Galectin-3 levels were higher in the CHF patients with severe LVD (p <0.001*) compared to moderate LVD patients. Pearson's correlation analysis showed a significant positive correlation between Galectin-3 levels and NYHA class III, IV and echocardiographic indices (LVIDD, LVIDS, LVESV, LVEDV) and significant negative correlation between LVEF and Galectin-3 levels. CONCLUSIONS Serum Galectin-3 levels being higher in CHF patients with severe LVD compared to moderate LVD and significant positive correlation between Galectin-3 levels between NYHA class III, IV and LVEDD, LVESD, LVEDV, LVESV while there is a significant negative correlation between Galectin-3 levels and LVEF, thus proving that Galectin-3 levels are closely correlated with the degree of left ventricular structural and functional remodelling in CHF patients.
Annals of Medicine, 2011
Aims. galectin-3 is an emerging biomarker which has been studied in relatively small heart failure (Hf) cohorts with predominantly systolic Hf. We studied the prognostic value of base-line galectin-3 in a large Hf cohort, with preserved and reduced left ventricular ejection fraction (lvef), and compared this to other biomarkers. Methods. We studied 592 Hf patients who had been hospitalized for Hf and were followed for 18 months. The primary end-point was a composite of all-cause mortality and Hf hospitalization. Results. A doubling of galectin-3 levels was associated with a hazard ratio (HR) of 1.97 (1.62-2.42) for the primary outcome (P 0.001). After correction for age, gender, BnP, egfR, and diabetes the HR was 1.38 (1.07-1.78; P 0.015). galectin-3 levels were correlated with higher il-6 and CRP levels (P 0.002). Changes of galectin-3 levels after 6 months did not add prognostic information to the base-line value (n 291); however, combining plasma galectin-3 and BnP levels increased prognostic value over either biomarker alone (RoC analysis, P 0.05). The predictive value of galectin-3 was stronger in patients with preserved lvef (n 114) compared to patients with reduced lvef (P 0.001). Conclusions. galectin-3 is an independent marker for outcome in Hf and appears to be particularly useful in Hf patients with preserved lvef.
Galectin-3: a potential biomarker for diagnostics of heart failure
2018
Heart failure is a dysfunction with varied ethology; one of possible causes is anticancer treatment with anthracyclines. Rapid diagnosis is important because the disease is associated with high mortality and morbidity. The only biomarkers fully approved for diagnostics of heart failure are natriuretic peptides. They are secreted by ventricular muscle cells in response to volume and pressure overload. However, their concentration can be influenced by other factors, such as age or gender. A potential marker, not affected by these issues might be galectin-3. Current studies showed that galectin can play particularly significant role in myocardial fibrosis and inflammation. Elevated galectin-3 concentration has been observed in such cardiovascular diseases as heart failure, atherosclerosis, stroke and myocardial infarction. The review summarizes results of studies which indicate the role of galectin-3 in inducing fibrosis and cardiac remodelling (processes which influence disease progr...
Acta Facultatis Medicae Naissensis, 2017
Summary The aim of our study was to determine the factors influencing galectin-3 levels in patients with acute coronary syndrome and decreased left ventricular ejection fraction. We collected material from 37 successive patients with acute coronary syndrome and decreased left ventricular ejection fraction, of which 19 patients had atrial fibrillation, and 18 patients who were without atrial fibrillation constituted a control group. Blood samples used for the biochemical measurements were obtained on the third day from acute coronary syndrome. We used Statistical Package for Social Sciences for data analysis. A p-value less than 0.05 was considered to be a measure of statistical significance. Galectin-3 concentration is directly correlated with age and B-type natriuretic peptide level. Also, our results showed an inverse correlation between galectin-3 and total body weight, body mass index, body surface area and creatinine clearance. The following variables were found to be significa...
Prognostic Value of Galectin-3 in Patients with Heart Failure
Disease Markers, 2015
Galectins are a family of solubleβ-galactoside-binding lectins that have important role in inflammation, immunity, and cancer. Galectin-3 as a part of this lectin family plays a very important role in development of heart failure. According to recent papers, galectin-3 plasma level correlates with heart failure outcome, primarily with rehospitalisation and death from heart failure. This paper summarizes the most recent advances in galectin-3 research, with the accent on the role of galectin-3 in pathophysiology of myocardial remodelling and heart failure development—with preserved and reduced ejection fraction, and some implication on development of new disease modifying drugs.
Journal of surgery and medicine, 2020
Aim: Cardiac fibrosis, a pathological phenomenon in cardiac remodeling, is associated with heart diseases. The aim of this study was to investigate the relationship of Galectin-3 with N-terminal pro B-type natriuretic peptide (NT-pro-BNP) levels in patients with heart failure (HF). Methods: A total of 50 patients with HF (patient group) and 30 subjects with normal ejection fractions (control group) were enrolled in this study. Serum galectin-3 levels and plasma NT-pro-BNP were measured in all subjects. Demographic and clinical characteristics of the patients were recorded. The Galectin-3 and NT-pro-BNP levels were compared between the groups. Results: Patients with HF had significantly higher Galectin-3 and NT-pro-BNP levels than control subjects (37.5 (18.0-80.0) versus 12.00 (8.00-14.00), P<0.001; 467.0 (1157.5-5107.2) versus 50.0 (35.0-102.0), P<0.001, respectively). Galectin-3 was correlated with serum glucose, creatine, left atrial diameter, ejection fraction and NT-pro-BNP in the HF patients. There was a positive and significant correlation between the NT-pro-BNP and Galectin-3 levels (r=0.742, P=0.001). In addition, there was an inverse and significant correlation between the ejection fraction and Galectin-3 levels (r=-0.556, P=0.001). Conclusion: The present study demonstrates that galectin-3 and NT-pro-BNP levels are significantly higher in patients with systolic HF. Galectin-3 was positively and significantly correlated with the NT-pro-BNP and inversely correlated with ejection fraction.
Scientific Reports
Galectin-3 is a biomarker of heart disease. However, it remains unknown whether increase in galectin-3 levels is dependent on aetiology or disease-associated conditions and whether diseased heart releases galectin-3 into the circulation. We explored these questions in mouse models of heart disease and in patients with cardiomyopathy. All mouse models (dilated cardiomyopathy, DCM; fibrotic cardiomyopathy, ischemia-reperfusion, I/R; treatment with β-adrenergic agonist isoproterenol) showed multi-fold increases in cardiac galectin-3 expression and preserved renal function. In mice with fibrotic cardiomyopathy, I/R or isoproterenol treatment, plasma galectin-3 levels and density of cardiac inflammatory cells were elevated. These models also exhibited parallel changes in cardiac and plasma galectin-3 levels and presence of trans-cardiac galectin-3 gradient, indicating cardiac release of galectin-3. DCM mice showed no change in circulating galectin-3 levels nor trans-cardiac galectin-3 gradient or myocardial inflammatory infiltration despite a 50-fold increase in cardiac galectin-3 content. In patients with hypertrophic cardiomyopathy or DCM, plasma galectin-3 increased only in those with renal dysfunction and a trans-cardiac galectin-3 gradient was not present. Collectively, this study documents the aetiology-dependency and diverse mechanisms of increment in circulating galectin-3 levels. Our findings highlight cardiac inflammation and enhanced β-adrenoceptor activation in mediating elevated galectin-3 levels via cardiac release in the mechanism. Galectin-3 (Gal-3) is a β-galactoside-binding lectin that binds to glycoproteins thereby regulating their activities 1. Clinical studies have shown that high circulating Gal-3 levels are indicative of severity of heart diseases or associated with increased risk of major adverse cardiovascular events including heart failure (HF) 2 , arrhythmias 3-5 , arterial stiffening 6 , re-hospitalization post-HF discharge 7 , diastolic dysfunction 8 , severity of atrial fibrosis 5,9 or mortality 10,11. However, a lack of association of Gal-3 levels and disease severity has also been reported in some studies 12-15. The mechanism(s) responsible for increased blood levels of Gal-3 remains incompletely defined. While increased cardiac Gal-3 expression was observed in human cardiac biopsies 5,9,16,17 , cardiac release of Gal-3 is not evident in patients with atrial fibrillation or severe HF indicated by the absence of a trans-cardiac Gal-3 gradient 18,19. A positive correlation between blood and myocardial levels of Gal-3 was reported in one study 20 , but not in another study 16. Clinical studies have consistently reported a strong and negative correlation between circulating Gal-3 levels and estimated glomerular filtration rate (eGFR), indicating that renal dysfunction is a determinant of blood Gal-3 levels 13,21-23. Indeed, Gal-3 levels are markedly elevated in patients with end-stage renal failure 24 .
Galectin-3 in Ambulatory Patients With Heart Failure: Results From the HF-ACTION Study
Circulation: Heart Failure, 2011
Background-Galectin-3 is a soluble ß-galactoside-binding lectin released by activated cardiac macrophages. Elevated levels of galectin-3 have been found to be associated with adverse outcomes in patients with heart failure. We evaluated the association between galectin-3 and longterm clinical outcomes in ambulatory heart failure patients enrolled in the HF-ACTION study.