title: Galectin-3 and left ventricular reverse remodelling after surgical mitral valve repair.
abstract: OBJECTIVE
  Mitral valve repair in patients with functional mitral regurgitation (FMR) has been associated with beneficial left ventricular (LV) reverse remodelling. Recently, galectin-3 emerged as a marker of myocardial inflammation and fibrosis which may influence LV remodelling after surgery. The aim of the current study was to evaluate the association between pre-operative galectin-3 levels and LV reverse remodelling in heart failure patients with significant FMR who underwent mitral valve repair.
  
  
  RESULTS
  In total, 42 heart failure patients (66 ± 10 years, 69% male) were evaluated. Plasma galectin-3 levels were assessed pre-operatively. Two-dimensional echocardiographic parameters were measured at baseline, and at 6 and 12 months after surgery. LV reverse remodelling was defined as a decrease in LV end-systolic volume ≥15% at 6 months follow-up. In total, 57% of the patients showed LV reverse remodelling. Patients with LV reverse remodelling showed significantly lower pre-operative galectin-3 levels (17.5 ± 5.6 vs. 23.7 ± 9.9 ng/mL, P = 0.009) compared with patients without LV reverse remodelling. In addition, patients with galectin-3 ≤18.2 ng/mL had a six-fold higher probability of showing LV reverse remodelling after surgery as compared with patients with levels >18.2 ng/mL (odds ratio 6.58, 95% confidence interval 1.32-33.33, P = 0.02).
  
  
  CONCLUSIONS
  High pre-operative plasma galectin-3 is independently associated with the absence of LV reverse remodelling after mitral valve repair. Galectin-3 may be useful to identify heart failure patients who will need additional treatment to obtain beneficial LV reverse remodelling.
authors.affiliation: Department of Cardiothoracic Surgery, Leiden University Medical Center, The Netherlands. k.a.kortekaas@lumc.nl
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Kortekaas
authors.forename: Georgette E
authors.initials: GE
authors.lastname: Hoogslag
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: de Boer
authors.forename: Martin M
authors.initials: MM
authors.lastname: Dokter
authors.forename: Michel I M
authors.initials: MI
authors.lastname: Versteegh
authors.forename: Jerry
authors.initials: J
authors.lastname: Braun
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Hariette F
authors.initials: HF
authors.lastname: Verwey
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Robert J M
authors.initials: RJ
authors.lastname: Klautz
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Galectin-3; Heart failure; Mitral valve repair; Reverse remodelling