Galectin-3 in Patients with Acute Heart Failure: Preliminary Report on First Polish Experience

Abstract

Background: Galectin-3 (Gal-3) as a biomarker of fibrosis and inflammation has been implicated in the development and progression of heart failure (HF) and may predict increased morbidity and mortality in society.

Objectives: In this preliminary report we investigated the utility of a novel serum marker for the diagnosis of acute HF (AHF).

Material and methods: The study involved 14 AHF patients aged 67.0 ± 14.6 yrs. with left ventricular ejection fraction (LVEF) 29.29 ± 10.73%, hospitalized at the Intensive Coronary Care Unit, where the research took place. In addition, a control group consisting of 19 volunteers who were age, gender and ethnically matched to the HF group was recruited. In the study group, the concentrations of Gal-3, NT-proBNP, hsCRP and basic clinical parameters, such as prevalence of dyspnea and LVEF were determined. The concentration of Gal-3 in serum was examined by an automated quantitative test (VIDAS® Galectin-3, bioMerieux SA, France) using the ELFA technique. The survival rate was assessed after a 12-month follow-up.

Results: The median (IQR) Gal-3 concentrations in patients with AHF were higher (nearly 2.1-times) than in the control group - 17.8 (10.3-27.8) ng/mL vs. 8.4 (6.5-11.0) ng/mL; p = 0.0007. In our study group, the median (IQR) of concentrations of NT-proBNP 4723 (1415-29725) pg/mL and hsCRP 10.0 (4.9-13.9) mg/L were observed. In those patients, the statistically significant correlation (Spearman's rank-correlation coefficient) between the concentrations of Gal-3 and NT-proBNP (Rs = 0.565; p = 0.035) as well as the value of LVEF and the concentration of hsCRP (Rs = -0.663; p = 0.020) were stated. The serum Gal-3 concentrations were significantly higher among the 4 HF patients (28.6%) who had died than among the HF patients who were alive after this time (n = 10) (55.6 ± 37.6 ng/mL vs. 15.0 ± 7.04 ng/mL; p = 0.005).

Conclusions: Higher expression of Gal-3 is an indicator of myocardial fibrosis and remodeling in decompensated HF. Therefore, galectin-3 seems to be an interesting and valuable marker of AHF.

Keywords: NT-proBNP; acute heart failure; biomarkers; galectin-3; left ventricle ejection fraction.