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Relationship of galectin-3 to left ventricular geometry and hypertrophy in chronic hemodialysis patients

Beziehung von Galectin-3 zu linksventrikulärer Geometrie und Hypertrophie bei chronischen Hämodialysepatienten

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Abstract

Aim and background

Galectin-3 (Gal-3) is used to determine the prognosis of heart failure. Some studies revealed that Gal-3 promoted cardiac hypertrophy but there is no study in which the relationship between Gal-3 and left ventricular hypertrophy (LVH) geometry in patients without diastolic and systolic function impairment has been explored. The aim of the study was to analyze associations between plasma Gal-3 levels, LVH, and LV geometry in maintenance hemodialysis (HD) patients without systolic and diastolic dysfunction.

Patients and methods

The study group included 105 patients (53 women and 52 men)—with an average age of 58.2 ± 12.6 years, treated with HD for an average of 45 ± 32 months—and 60 healthy controls. The Gal-3 and other biochemical parameters were measured and color Doppler echocardiography was performed. For this study LVH was considered present when the LV mass index (LVMI) exceeded 95 g/m2 in women and 115 g/m2 in men. Left ventricular geometry was classified into the four groups on the basis of left ventricular mass and relative wall thickness (RWT).

Results

Concentric hypertrophy (CH, 40.9 %, n = 43) was the commonest geometric pattern in our study. The Gal-3 levels in CH patients were not different from the patients with eccentric hypertrophy (EH). Plasma levels of Gal-3 correlated with LVMI (r = 0.617, p < 0.001), parathyroid hormone (PTH, r = 0.408, p < 0.001), uric acid (r = 0.281, p = 0.004), C-reactive protein (CRP, r = 0.412, p < 0.001), and RWT (r = 0.281, p = 0.004) but were inversely correlated with albumin (r = − 0.466, P < 0.001) in the whole group. Plasma levels of Gal-3 were associated with LVMI (r = 0.812, P < 0.001), RWT (r = 0.318, p = 0.001), and CRP(r = 0.381, p < 0.001) in maintenance hemodialysis patients.

Conclusion

The Gal-3 level is related to left ventricular hypertrophy and it is independent of left ventricle geometry. The relationship between LVH and Gal-3 might be direct or it may also be inflammation-related.

Zusammenfassung

Ziel und Hintergrund

Galectin-3 (Gal-3) wird zur Ermittlung der Prognose bei Herzinsuffizienz eingesetzt. Einige Studien haben gezeigt, dass Gal-3 eine kardiale Hypertrophie begünstigt, aber es gibt bisher keine Studie, in der die Beziehung zwischen Gal-3 und geometrischen Parametern einer linksventrikulären Hypertrophie (LVH) bei Patienten ohne diastolische und systolische Funktionseinschränkung untersucht wurde. Ziel dieser Studie war es, Zusammenhänge zwischen dem Gal-3-Spiegel im Plasma, LVH und LV-Geometrie bei Patienten mit Erhaltungsdialyse (Hämodialyse, HD) ohne systolische und diastolische Funktionsstörung zu untersuchen.

Methoden

Die Gruppe der Studienteilnehmer umfasste 105 Patienten (53 w, 52 m) mit einem Durchschnittsalter von 58,2 ± 12,6 Jahren, die durchschnittlich seit 45 ± 32 Monaten unter HD-Behandlung standen, und 60 gesunde Kontrollen. Es wurden Gal-3 und einige Laborparameter bestimmt sowie eine Farbdopplerechokardiographie durchgeführt. Für diese Studie wurde vom Vorliegen einer LVH ausgegangen, wenn der LV-Massenindex (LVMI) 95 g/m2 bei Frauen und 115 g/m2 bei Männern überstieg. Die LV-Geometrie wurde in 4 Gruppen eingeteilt, je nach LV-Masse und relativer Wanddicke (RWT, „relative wall thickness“).

Ergebnisse

Die konzentrische Hypertrophie (CH, 40,9 %, n = 43) war das häufigste geometrische Muster in der vorliegenden Studie. Der Gal-3-Spiegel bei CH-Patienten unterschied sich nicht von dem der Patienten mit ekzentrischer Hypertrophie (EH). Die Plasmaspiegel von Gal-3 waren mit dem LVMI (r = 0,617; p < 0,001), Parathormon (PTH, r = 0,408; p < 0,001), Harnsäure (r = 0,281; p= 0,004), C-reaktivem Protein (CRP, r = 0,412; p < 0,001) und der RWT (r = 0,281; p= 0,004) korreliert, aber es bestand eine inverse Korrelation mit Albumin (r = − 0,466; p < 0,001) in der ganzen Gruppe. Bei Patienten mit Erhaltungsdialyse standen die Plasmaspiegel von Gal-3 mit dem LVMI (r = 0,812; p < 0,001), der RWT (r = 0,318; p= 0,001) und CRP (r = 0,381; p < 0,001) in Zusammenhang.

Schlussfolgerung

Den Ergebnissen zufolge steht Gal-3 in einem Zusammenhang mit einer LV-Hypertrophie, ist aber unabhängig von der LV-Geometrie. Es könnte eine unmittelbare oder auch eine entzündungsbedingte Beziehung zwischen LVH und Gal-3 bestehen.

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Compliance with ethical guidelines

Conflict of interest. H. Yilmaz, O. M. Gurel, H.T. Celik, A. Bozkurt, M.E. Yildirim, I. Bilgic, M.A. Bilgic, N. Bavbek, and A. Akcay state that they have no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Nephrology, Turgut Ozal University, School of Medicine, Alparslan Türkes Cad. No: 57, 06510, Emek/Ankara, Turkey

    H. Yilmaz, M.A. Bilgic, N. Bavbek & A. Akcay

  2. Department of Cardiology, Turgut Ozal University, School of Medicine, Ankara, Turkey

    O.M. Gurel

  3. Department of Biochemistry, Turgut Ozal University, School of Medicine, Ankara, Turkey

    H.T. Celik

  4. Department of Interventional Radiology, Turgut Ozal University, School of Medicine, Ankara, Turkey

    A. Bozkurt

  5. Department of Urology, Turgut Ozal University, School of Medicine, Ankara, Turkey

    M.E. Yildirim

  6. Department of General Surgery, Turgut Ozal University, School of Medicine, Ankara, Turkey

    I. Bilgic

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Correspondence to H. Yilmaz.

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Yilmaz, H., Gurel, O., Celik, H. et al. Relationship of galectin-3 to left ventricular geometry and hypertrophy in chronic hemodialysis patients. Herz 40, 702–708 (2015). https://doi.org/10.1007/s00059-014-4111-4

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  • DOI: https://doi.org/10.1007/s00059-014-4111-4

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