Dynamics and prognostic role of galectin-3 in patients with advanced heart failure, during left ventricular assist device support and following heart transplantation.
Galectin-3 is a marker of myocardial inflammation and fibrosis shown to correlate with morbidity and mortality in heart failure (HF). We examined the utility of galectin-3 as a marker of the severity of HF, the response of galectin-3 levels to ventricular assist device (LVAD) implantation or heart transplantation (HTx), and its use as a prognostic indicator.



Plasma galectin-3 was measured using a commercially available ELISA assay in patients with stable HF (n = 55), severe HF (n = 63), at 3 (n = 17) and 6 (n = 14) months post-LVAD and at LVAD explantation (n = 23), patients following HTx (n = 85) and healthy controls (n = 30).



Galectin-3 levels increase with the severity of HF (severe HF: 28.2 ± 14, stable HF: 19.7 ± 13, p = 0.001; controls: 13.2 ± 9 ng/ml, p = 0.02 versus stable HF). Following LVAD implantation, galectin-3 levels are initially lower (3 months: 23.7 ± 9, 6 months: 21.7 ± 9 versus 29.2 ± 14 ng/ml implantation; p = NS) but are higher at explantation (40.4 ± 19 ng/ml; p = 0.005 versus pre-LVAD). Galectin-3 levels >30 ng/ml are associated with lower survival post-LVAD placement (76.5 % versus 95.0 % at 2 years, p = 0.009). After HTx, galectin-3 levels are lower (17.8 ± 7.1 ng/ml post-HTx versus 28.2 ± 14 pre-HTx; p < 0.0001). Patients with coronary allograft vasculopathy (CAV) post-HTx showed higher galectin-3 levels (20.5 ± 8.8 ng/ml versus 16.8 ± 6.3, p = 0.1) and the degree of CAV correlated with levels of galectin-3 (r (2) = 0.17, p < 0.0001).



Galectin-3 is associated with the severity of HF, exhibits dynamic changes during mechanical unloading and predicts survival post-LVAD. Further, galectin-3 is associated with the development on CAV post-HTx. Galectin-3 might serve as a novel biomarker in patients with HF, during LVAD support and following HTx.
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Ellie
E
Coromilas
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Em-Claire
EC
Que-Xu
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
D'Vesharronne
D
Moore
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Tomoko S
TS
Kato
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Christina
C
Wu
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Ruiping
R
Ji
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Raymond
R
Givens
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Ulrich P
UP
Jorde
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Hiroo
H
Takayama
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Yoshifumi
Y
Naka
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Isaac
I
George
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA.
Donna
D
Mancini
Department of Medicine, Division of Cardiology, Columbia University Medical Center, 166 Fort Washington Avenue, New York, NY, 10032, USA. christian.schulze@med.uni-jena.de.|Department of Medicine, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07743, Jena, Germany. christian.schulze@med.uni-jena.de.
P Christian
PC
Schulze
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D001798:Blood Proteins; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
Coronary Allograft Vasculopathy; Galectin-3; Heart Failure; Heart Transplantation; LVAD