title: Galectin 3: association to neurohumoral activity, echocardiographic parameters and renal function in outpatients with heart failure.
abstract: Galectin 3 (Gal-3) reflects cardiac fibrosis in heart failure HF, but has also been associated to renal fibrosis and impaired renal function. Previous research has suggested that Gal-3 could be a cardio-renal biomarker, but it has never been tested simultaneous in a single study whether Gal-3 reflects echocardiographic measures, neurohumoral activity and renal function. The aim of this study was to evaluate the relationship between plasma concentrations of Gal-3 and neurohumoral activity, myocardial and renal function in patients with HF, including advanced echocardiographic measures and 24-h urinary albumin excretion (albuminuria).
  
  
  
  We prospectively enrolled 132 patients with reduced left ventricular ejection fraction (LVEF) referred to an outpatient HF clinic. The patients had a median age of 70 years (interquartile rage: 64-75), 26.5 % were female, median LVEF was 33 % (27-39 %) and 30 % were in NYHA class III-IV.
  
  
  
  Patients with plasma concentrations of Gal-3 above the median had significantly lower estimated glomerular filtration rate (eGFR) and this association remained significant in multivariate regression analysis (β: -0.010; 95 % CI -0.012--0.008; P < 0.001), adjusted for age, gender, medical treatment. Plasma concentrations of Gal-3 were not associated with albuminuria (Beta: 0.008; 95 % CI:-0.028-0.045; P = 0.652). There were no association between plasma concentrations of Gal-3 and myocardial function or structure estimated by LVEF, LVmassIndex, LVIDd, E/é or LV global longitudinal strain (P > 0.05 for all). In multivariate analyses plasma concentrations of Gal-3 were significantly associated with the cardiac biomarkers: NT-proBNP (β: 0.047; 95 % CI: 0.008-0.086; P = 0.020), proANP (β: 0.137; 95 % CI: 0.067-0.207; P < 0.001), chromogranin A (β: 0.123; 95 % CI: 0.052-0.194; P < 0.001) and Copeptin (β: 0.080; 95 % CI: 0.000-0.160; P = 0.049). Multivariate analysis was adjusted for eGFR, age, gender and medical treatment.
  
  
  
  Increased plasma concentrations of Gal-3 are associated with reduced eGFR and increased plasma concentrations of NT-proBNP, proANP, chromogranin A and Copeptin, but not with echocardiographic parameters reflecting myocardial function. These results suggest that Gal-3 reflects both increased neurohumoral activity and reduced eGFR, but not myocardial function in patients with systolic HF.
authors.affiliation: Department of Cardiology, Herlev University Hospital, Herlev, Denmark. freja.stoltze.gaborit@regionh.dk.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. freja.stoltze.gaborit@regionh.dk.
authors.forename: Freja
authors.initials: F
authors.lastname: Stoltze Gaborit
authors.affiliation: Department of Internal Medicine KNEA, North Zealand University Hospital, Hillerod, Denmark.|Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Bosselmann
authors.affiliation: Department of Internal Medicine, Endocrinology Unit, Herlev University Hospital, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
authors.affiliation: Department of Cardiology, Herlev University Hospital, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.affiliation: Department of Cardiology, Herlev University Hospital, Herlev, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kumler
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Jens P
authors.initials: JP
authors.lastname: Goetze
authors.affiliation: Department of Clinical Biochemistry, North Zealand University Hospital, Hillerod, Denmark.
authors.forename: György
authors.initials: G
authors.lastname: Sölétormos
authors.affiliation: Department of Internal Medicine KNEA, North Zealand University Hospital, Hillerod, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Tønder
authors.affiliation: Department of Cardiology, Herlev University Hospital, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D016009:Chi-Square Distribution; D053379:Chromogranin A / Q000097:blood; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D005919:Glomerular Filtration Rate; D006020:Glycopeptides / Q000097:blood; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010045:Outpatients; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; C506150:CHGA protein, human; D053379:Chromogranin A; D037502:Galectin 3; D037161:Galectins; D006020:Glycopeptides; C428445:LGALS3 protein, human; D010446:Peptide Fragments; C048197:copeptins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor
keywords: Echocardiography; Galectin 3; Heart failure reduced ejection fraction; Natriuretic peptides; Renal function