title: Serial measurement of galectin-3 in patients with chronic heart failure: results from the ProBNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) study.
abstract: OBJECTIVE
  Galectin-3 is a prognostic heart failure (HF) biomarker that may mediate cardiac fibrosis. We examined the value of serial galectin-3 measurement for prognosis and response to therapy in chronic HF.
  
  
  RESULTS
  A total of 151 subjects with LV systolic dysfunction (LVSD) were followed through 908 visits over 10 ± 3 months. The amount of time spent with a galectin-3 level ≤ 20.0 ng/mL and changes between baseline and subsequent values were considered across visits, and used to assess risk for adverse cardiovascular (CV) events and associations with LV remodelling. Medication effects on galectin-3 were examined. Median galectin-3 values at baseline, 3 months, and 6 months were higher in patients with CV events (21.7 vs. 18.4 ng/mL, P = 0.03; 21.7 vs. 16.5 ng/mL, P = 0.03; 23.2 vs. 16.0 ng/mL, P = 0.007). Galectin-3 concentration changed in 35.2% of subjects during study procedures; time spent at ≤ 20.0 ng/mL was significantly associated with a lower rate of CV events, independently predicted fewer CV events even adjusted for relevant variables including study allocation, NT-proBNP, and renal function [odds ratio (OR) = 0.90; P = 0.05], and predicted increase in LV ejection fraction (OR = 1.20; P = 0.04). Serial galectin-3 measurement at 6 months added prognostic value beyond the baseline level (P = 0.02). There were no significant effects of medications on galectin-3 levels.
  
  
  CONCLUSIONS
  In chronic HF due to LVSD, serial galectin-3 measurement adds incremental prognostic information and predicts LV remodelling. In this study, HF therapies had no clear effects on galectin-3 levels.
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Shweta R
authors.initials: SR
authors.lastname: Motiwala
authors.forename: Jackie
authors.initials: J
authors.lastname: Szymonifka
authors.forename: Arianna
authors.initials: A
authors.lastname: Belcher
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Baggish
authors.forename: Patrick
authors.initials: P
authors.lastname: Sluss
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Gaggin
authors.forename: Anju
authors.initials: A
authors.lastname: Bhardwaj
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D002908:Chronic Disease; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D016896:Treatment Outcome; D020257:Ventricular Remodeling
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D001798:Blood Proteins; D004232:Diuretics; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Biomarkers; Galectin-3; Heart failure; Outcomes; Prognosis; Remodelling