title: Galectin-3, a marker of cardiac fibrosis, predicts incident heart failure in the community.
abstract: OBJECTIVE
  The aim of this study was to examine the relation of galectin-3 (Gal-3), a marker of cardiac fibrosis, with incident heart failure (HF) in the community.
  
  
  BACKGROUND
  Gal-3 is an emerging prognostic biomarker in HF, and experimental studies suggest that Gal-3 is an important mediator of cardiac fibrosis. Whether elevated Gal-3 concentrations precede the development of HF is unknown.
  
  
  METHODS
  Gal-3 concentrations were measured in 3,353 participants in the Framingham Offspring Cohort (mean age 59 years; 53% women). The relation of Gal-3 to incident HF was assessed using proportional hazards regression.
  
  
  RESULTS
  Gal-3 was associated with increased left ventricular mass in age-adjusted and sex-adjusted analyses (p = 0.001); this association was attenuated in multivariate analyses (p = 0.06). A total of 166 participants developed incident HF and 468 died during a mean follow-up period of 11.2 years. Gal-3 was associated with risk for incident HF (hazard ratio [HR]: 1.28 per 1 SD increase in log Gal-3; 95% confidence interval [CI]: 1.14 to 1.43; p < 0.0001) and remained significant after adjustment for clinical variables and B-type natriuretic peptide (HR: 1.23; 95% CI: 1.04 to 1.47; p = 0.02). Gal-3 was also associated with risk for all-cause mortality (multivariable-adjusted HR: 1.15; 95% CI: 1.04 to 1.28; p = 0.01). The addition of Gal-3 to clinical factors resulted in negligible changes to the C-statistic and minor improvements in net reclassification improvement.
  
  
  CONCLUSIONS
  Higher concentration of Gal-3, a marker of cardiac fibrosis, is associated with increased risk for incident HF and mortality. Future studies evaluating the role of Gal-3 in cardiac remodeling may provide further insights into the role of Gal-3 in the pathophysiology of HF.
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Ho
authors.forename: Chunyu
authors.initials: C
authors.lastname: Liu
authors.forename: Asya
authors.initials: A
authors.lastname: Lyass
authors.forename: Paul
authors.initials: P
authors.lastname: Courchesne
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis / Q000097:blood; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000401:mortality; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D020097:Natriuretic Peptide, Brain