title: Determinants and prognostic value of Galectin-3 in patients with aortic valve stenosis.
abstract: Myocardial fibrosis has been proposed as an outcome predictor in asymptomatic patients with severe aortic stenosis (AS) that may lead to consider prophylactic surgery. It can be detected using MRI but its widespread use is limited and development of substitute biomarkers is highly desirable. We analysed the determinants and prognostic value of galectin-3, one promising biomarker linked to myocardial fibrosis.
  
  
  
  Patients with at least mild degenerative AS enrolled between 2006 and 2013 in two ongoing studies, COFRASA/GENERAC (COhorte Française de Rétrécissement Aortique du Sujet Agé/GENEtique du Rétrécissement Aortique), aiming at assessing the determinants of AS occurrence and progression, constituted our population.
  
  
  
  We prospectively enrolled 583 patients. The mean galectin-3 value was 14.3±5.6 ng/mL. There was no association between galectin-3 and functional status (p=0.55) or AS severity (p=0.58). Independent determinants of galectin-3 were age (p=0.0008), female gender (p=0.04), hypertension (p=0.002), diabetes (p=0.02), reduced left ventricular ejection fraction (p=0.01), diastolic dysfunction (E/e', p=0.02) and creatinine clearance (p<0.0001). Among 330 asymptomatic patients at baseline, galectin-3 was neither predictive of outcome in univariate analysis (p=0.73), nor after adjustment for age, gender, rhythm, creatinine clearance and AS severity (p=0.66).
  
  
  
  In a prospective cohort of patients with a wide range of AS severity, galectin-3 was not associated with AS severity or functional status. Main determinants of galectin-3 were age, hypertension and renal function. Galectin-3 did not provide prognostic information on the occurrence of AS-related events. Our results do not support the use of galectin-3 in the decision-making process of asymptomatic patients with AS.
  
  
  
  COFRASA NCT00338676 and GENERAC CT00647088.
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France INSERM U1148, Bichat Hospital, Paris, France Faculté de Médecine Paris-Diderot, University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Arangalage
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France INSERM U1148, Bichat Hospital, Paris, France Faculté de Médecine Paris-Diderot, University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Virginia
authors.initials: V
authors.lastname: Nguyen
authors.affiliation: Department of Biochemistry, Bichat Hospital, Paris, France.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Robert
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Melissopoulou
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Mathieu
authors.affiliation: Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, Paris, France.
authors.forename: Candice
authors.initials: C
authors.lastname: Estellat
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Codogno
authors.affiliation: Centre de Ressources Biologiques, Bichat Hospital, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Huart
authors.affiliation: Centre d'Investigation Clinique, Bichat Hospital, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Duval
authors.affiliation: Department of Cardiac Surgery, Bichat Hospital, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Cimadevilla
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France INSERM U1148, Bichat Hospital, Paris, France Faculté de Médecine Paris-Diderot, University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
authors.affiliation: Department of Biochemistry, Bichat Hospital, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Dehoux
authors.affiliation: Department of Cardiology, Bichat Hospital, Paris, France INSERM U1148, Bichat Hospital, Paris, France Faculté de Médecine Paris-Diderot, University Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Messika-Zeitoun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D015150:Echocardiography, Doppler; D005260:Female; D005355:Fibrosis; D005602:France; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human