title: Utility of galectin-3 in predicting post-infarct remodeling after acute myocardial infarction based on extracellular volume fraction mapping.
abstract: OBJECTIVE
  ST-segment elevation myocardial infarction (STEMI) triggers remote extracellular matrix expansion. Myocardial extracellular volume fraction (ECV), determined by cardiovascular magnetic resonance, permits quantification of interstitial space expansion. Our aim was to determine the relationship between early serum fibrosis biomarkers and 180-day post-infarct remote myocardium remodeling using ECV.
  
  
  RESULTS
  In 26 patients with STEMI, functional imaging, T1-mapping, and late-gadolinium-enhancement were performed on a 3-T CMR scanner at baseline (days 3 to 5) and 180days. Biomarkers were measured at days 1, 3, and 7 after STEMI. The mean initial and follow-up left ventricular ejection fraction (LVEF) were 48.3±18.1% and 52.6±12.3%, respectively. Initial infarct size was 11.6±16.8% of LV mass. ECV in the remote myocardium at 180days correlated with indexed end-systolic volume (r=0.4, p=0.045). A significant correlation was observed between galectin-3 at day 7 and ECV at 6months (r=0.428, p=0.037). A trend towards a direct correlation was found for BNP (r=0.380, p=0.059). Multivariate analysis revealed that BNP and galectin-3 were independent predictors of long-term changes in ECV and explained nearly 30% of the variance in this parameter (r2=0.34; p=0.01). A galectin-3 cutoff value of 10.15ng/mL was the most powerful predictor of high ECV values (≥28.5%) at follow-up. Galectin-3 at day 7 was an independent predictor of high ECV values at follow-up (OR=22.51; CI 95%: 2.1-240.72; p=0.01) with 0.76 AUC (CI: 0.574-0.964; p=0.03).
  
  
  CONCLUSIONS
  Galectin-3 measured acutely after STEMI is an independent predictor of increased ECV at 6-month follow-up that might be useful for long-term risk stratification.
authors.affiliation: Department of Radiology, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Spain.
authors.forename: Rosario J
authors.initials: RJ
authors.lastname: Perea
authors.affiliation: Department of Biochemistry and Molecular Genetics, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigaciones Biomedicas en Red en Enfermedades Hepaticas y Digestivas (CIBERehd), Barcelona, Spain; Department of Physiological Sciences I, University of Barcelona, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Morales-Ruiz
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Jose T
authors.initials: JT
authors.lastname: Ortiz-Perez
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Andreu
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Roger
authors.initials: R
authors.lastname: Borras
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Acosta
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Penela
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Susanna
authors.initials: S
authors.lastname: Prat-González
authors.affiliation: Department of Radiology, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Spain.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: de Caralt
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Martínez
authors.affiliation: Department of Biochemistry and Molecular Genetics, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigaciones Biomedicas en Red en Enfermedades Hepaticas y Digestivas (CIBERehd), Barcelona, Spain.
authors.forename: Blai
authors.initials: B
authors.lastname: Morales-Romero
authors.affiliation: Siemens Healthcare Diagnostics Inc., Tarrytown, NY, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Lasalvia
authors.affiliation: Siemens Healthcare Diagnostics Inc., Tarrytown, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Donnelly
authors.affiliation: Department of Biochemistry and Molecular Genetics, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigaciones Biomedicas en Red en Enfermedades Hepaticas y Digestivas (CIBERehd), Barcelona, Spain; Department of Physiological Sciences I, University of Barcelona, Barcelona, Spain.
authors.forename: Wladimiro
authors.initials: W
authors.lastname: Jiménez
authors.affiliation: Department of Biochemistry and Molecular Genetics, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigaciones Biomedicas en Red en Enfermedades Hepaticas y Digestivas (CIBERehd), Barcelona, Spain; Department of Physiological Sciences I, University of Barcelona, Barcelona, Spain.
authors.forename: Aurea
authors.initials: A
authors.lastname: Mira
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Mont
authors.affiliation: Cardiology Department, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain. Electronic address: berruezo@clinic.ub.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Berruezo
mesh_terms: D015415:Biomarkers / Q000097:blood; D005109:Extracellular Matrix / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D037502:Galectin 3
keywords: Extracellular volume fraction; Galectin-3; Myocardial infarction; Remodeling; T1 mapping