title: Galectin-3 and myocardial fibrosis in nonischemic dilated cardiomyopathy.
abstract: BACKGROUND
  Left ventricular (LV) fibrosis, assessed by late gadolinium enhancement (LGE) at cardiac magnetic resonance imaging (MRI), is a marker of LV remodeling, and holds prognostic value in nonischemic dilated cardiomyopathy (NICM). Galectin-3 has been shown to participate in tissue fibrogenesis and to be a prognosticator in heart failure. Our aim was to investigate the relationships between galectin-3 circulating level and myocardial fibrosis at MRI in patients with NICM.
  
  
  RESULTS
  One-hundred-fifty patients were enrolled (males 73%; age 58, SD 14 years), with a NICM diagnosis according to the World Health Organization criteria. All patients underwent a comprehensive clinical assessment and biohumoral characterization, including galectin-3 assay, and cardiac MRI, with LGE assessment of fibrosis. Median galectin-3 value was 14.4 ng/mL (IQR 11.7-19.0 ng/mL), and LGE was detected in 106 (71%) patients. Patients with LGE had higher galectin-3 than those without (15.4, 11.8-21.0, vs 13.1, 11.7-16.4 ng/mL, p=0.006). Among univariate predictors of LGE presence (galectin-3, male sex, disease duration, arterial hypertension, left and right ventricular ejection fraction, left ventricular stroke volume), galectin-3 maintained its predictive value at multivariate analysis, together with sex, hypertension, disease duration and right ventricular ejection fraction. At receiver operating characteristic analysis the optimal galectin-3 cut-off for LGE prediction was 14.6 ng/mL (AUC 0.651, sensitivity 57%, specificity 73%).
  
  
  CONCLUSIONS
  Galectin-3 is associated with LGE-assessed myocardial replacement fibrosis in patients with NICM. These results support the hypothesis that galectin-3 is involved in cardiac fibrosis and remodeling in NICM, and that its assay may help to select subgroups at higher risk.
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Department of Heart and Vessels, University of Florence, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vergaro
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Del Franco
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Giannoni
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Prontera
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ripoli
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Masci
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.affiliation: Research Medical Unit INSERM U-942, Université Paris VII - Denis Diderot, Hôpital Lariboisière, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen Solal
authors.affiliation: Department of Heart and Vessels, University of Florence, Florence, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Padeletti
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Passino
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Department of Heart and Vessels, University of Florence, Florence, Italy. Electronic address: emdin@ftgm.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000175:diagnosis; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
keywords: Biomarkers; Cardiomyopathy, dilated; Late gadolinium enhancement; Magnetic resonance imaging; Myocardial fibrosis