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


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/E(a) 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).


CONCLUSIONS
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.
Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 32 Fruit Street, Yawkey 5984, Boston, MA 02114, USA.
Ravi V
RV
Shah
Annabel A
AA
Chen-Tournoux
Michael H
MH
Picard
Roland R J
RR
van Kimmenade
James L
JL
Januzzi
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D015415:Biomarkers; D003404:Creatinine / Q000378:metabolism / Q000652:urine; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D037502:Galectin 3 / Q000032:analysis*; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013599:Systole; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D037502:Galectin 3; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine