Galectin-3, cardiac structure and function, and long-term mortality in patients with acutely decompensated heart failure

• Published in: European journal of heart failure Vol. 12; no. 8; pp. 826 - 832
• Main Authors: Shah, Ravi V., Chen-Tournoux, Annabel A., Picard, Michael H., van Kimmenade, Roland R. J., Januzzi, James L.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-08-2010; Oxford University Press
• Subjects: Acute Disease; Acute Heart Failure; Age Factors; Aged; Biomarkers; Creatinine - metabolism; Creatinine - urine; Dyspnea - diagnostic imaging; Dyspnea - mortality; Dyspnea - physiopathology; Echocardiography; Echocardiography, Doppler; Female; Galectin 3 - analysis; Heart failure; Heart Failure, Systolic - diagnostic imaging; Heart Failure, Systolic - mortality; Heart Failure, Systolic - physiopathology; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Humans; Male; Mitral Valve Insufficiency; Multivariate Analysis; Natriuretic Peptide, Brain - analysis; Peptide Fragments - analysis; Prognosis; Proportional Hazards Models; Risk Factors; Statistics, Nonparametric; Systole; Time Factors; United States - epidemiology
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1093/eurjhf/hfq091

Aims
To determine the relationship between galectin‐3 concentrations and cardiac structure in patients with acute dyspnoea, and to evaluate the impact of galectin‐3 independent of echocardiographic measurements on long‐term mortality.
Methods and results
One hundred and fifteen patients presenting to the emergency department with acute dyspnoea who had galectin‐3 levels and detailed echocardiographic studies on admission were studied. Galectin‐3 levels were associated with older age (r = 0.26, P = 0.006), lower creatinine clearance (r = −0.42, P < 0.001), and higher levels of N‐terminal‐proBNP (r = 0.39, P < 0.001). Higher galectin‐3 levels were associated with tissue Doppler E/Ea ratio (r = 0.35, P = 0.01), a lower right ventricular (RV) fractional area change (r = −0.19, P = 0.05), higher RV systolic pressure (r = 0.37, P < 0.001), and more severe mitral (r = 0.30, P = 0.001) or tricuspid regurgitation (r = 0.26, P = 0.005). In patients diagnosed with heart failure (HF), the association between galectin‐3 and valvular regurgitation and RV systolic pressure persisted. In a multivariate Cox regression model, galectin‐3 remained a significant predictor of 4‐year mortality independent of echocardiographic markers of risk. Dyspnoeic patients with HF and galectin‐3 levels above the median value had a 63% mortality; patients less than the median value had a 37% mortality (P = 0.003).
Conclusion
Among dyspnoeic patients with and without ADHF, galectin‐3 concentrations are associated with echocardiographic markers of ventricular function. In patients with ADHF, a single admission galectin‐3 level predicts mortality to 4 years, independent of echocardiographic markers of disease severity.