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Galectin-3 is an independent marker for ventricular remodeling and mortality in patients with chronic heart failure

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Abstract

Background

Galectin-3 (Gal-3) is a recently discovered marker for myocardial fibrosis and elevated levels are associated with an impaired outcome after short-term follow-up in heart failure (HF) patients. However, whether Gal-3 is related to cardiac remodeling and outcome after long-term follow-up is unknown. Therefore, we determined the utility of Gal-3 as a novel biomarker for left ventricular remodeling and long-term outcome in patients with severe chronic HF.

Methods and results

A total of 240 HF patients with New York Heart Association (NYHA) Class III and IV were included. Patients were followed for 8.7 ± 1 years, had a mean age of 71 ± 0.6 years and 73 % of the study population was male. Circulating levels of NT-proBNP and Gal-3 were measured. Serial echocardiography was performed at baseline and at 3 months. At baseline median left ventricular end-diastolic volume (LVEDV) was 267 mL [interquartile range 232–322]. Patients were divided into three groups according to the change in LVEDV. Patients in whom the LVEDV decreased over time had significant lower levels of Gal-3 at entry compared to patients in whom the LVEDV was stable or increased (14.7 vs. 17.9 vs. 19.0 ng/mL; p = 0.004 for trend), whereas no significant differences were seen in levels of NT-proBNP (p = 0.33). Multivariate linear regression analyses revealed that Gal-3 levels were positively correlated to change in LVEDV (p = 0.007). In addition, Gal-3 was a significant predictor of mortality after long-term follow-up (p = 0.001).

Conclusion

Gal-3 is associated with left ventricular remodeling determined by serial echocardiography and predicts long-term mortality in patients with severe chronic HF.

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Abbreviations

DEAL-HF:

Deventer Alkmaar Heart Failure study

EF:

Ejection fraction

Gal-3:

Galectin-3

HF:

Heart failure

HFpEF:

Heart failure with a preserved ejection fraction

HFrEF:

Heart failure with a reduced ejection fraction

LVEDV:

Left ventricle end-diastolic volume

LVESV:

Left ventricular end-systolic volume

NPs:

Natriuretic peptides

NT-proBNP:

N-terminal part pro brain natriuretic peptide

ROC:

Receiver operating characteristic

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Acknowledgments

BG Medicine, Inc. has certain rights related to Galectin-3 measurements. BG Medicine, Inc. provided an unrestricted research grant to the Department of Cardiology of the University Medical Center Groningen, that employs dr. van der Meer, Lipsic, de Boer and van Veldhuisen. Dr. van Veldhuisen and de Boer have received consultancy and speaker’s fees from BG Medicine, Inc. The Deventer Cardiology Research department received an unrestricted research grant from BG Medicine Inc.

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Authors and Affiliations

  1. Deventer Hospital, Nico Bolkesteinlaan 75, 7415 CM, Deventer, The Netherlands

    Dirk J. Lok, Pieta W. Bruggink-André de la Porte, Erik Badings, Eric Lipsic, Jan van Wijngaarden & Peter van der Meer

  2. University Medical Center Utrecht, Utrecht, The Netherlands

    Sjoukje I. Lok

  3. University Medical Center Groningen, Groningen, The Netherlands

    Eric Lipsic, Rudolf A. de Boer, Dirk J. van Veldhuisen & Peter van der Meer

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  1. Dirk J. Lok
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  2. Sjoukje I. Lok
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  3. Pieta W. Bruggink-André de la Porte
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  4. Erik Badings
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  5. Eric Lipsic
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  6. Jan van Wijngaarden
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  7. Rudolf A. de Boer
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  8. Dirk J. van Veldhuisen
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  9. Peter van der Meer
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Correspondence to Dirk J. Lok.

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Lok, D.J., Lok, S.I., Bruggink-André de la Porte, P.W. et al. Galectin-3 is an independent marker for ventricular remodeling and mortality in patients with chronic heart failure. Clin Res Cardiol 102, 103–110 (2013). https://doi.org/10.1007/s00392-012-0500-y

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  • DOI: https://doi.org/10.1007/s00392-012-0500-y

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