Circulating Galectin-3 Levels Are Persistently Elevated After Heart Transplantation and Are Associated With Renal Dysfunction.
This study evaluated changes in serum levels of galectin (Gal)-3 before and after heart transplantation (HTx) and assessed the role of pre-HTx Gal-3 as a biomarker for post-HTx outcomes.



Gal-3 is a novel biomarker that reflects cardiac remodeling and fibrosis. Elevated serum Gal-3 levels are associated with poor prognosis in heart failure patients. Whether Gal-3 levels change following HTx and the significance of post-HTx outcomes are unknown.



Serum Gal-3 levels were measured in 62 patients at 118 days (Interquartile Range [IQR]: 23 to 798 days) before and 365 days (IQR: 54 to 767 days) post HTx. Cardiac tissue taken during routine post-HTx endomyocardial biopsy was evaluated to assess the correlation between tissue Gal-3 staining and serum Gal-3 levels and with the presence of myocardial hypertrophy and fibrosis.



Serum Gal-3 levels remained significantly elevated (>17.8 ng/ml) in 35 patients (56%) post HTx. There was a significant inverse correlation between Gal-3 levels and glomerular filtration rate measured before and after HTx (p > 0.005). There was no association between Gal-3 serum level and Gal-3 staining of myocardial tissue or with the presence of myocyte hypertrophy and interstitial fibrosis post HTx. Elevated pre-HTx Gal-3 levels were associated with reduced post-HTx exercise capacity, but this association was not significant after adjustment for age, body mass index, and glomerular filtration rate.



This is the first study to demonstrate the fact that Gal-3 levels remain elevated in the majority of patients despite HTx and is associated with renal dysfunction. Our findings suggest Gal-3 is a systemic rather than cardiac-specific biomarker.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Avishay
A
Grupper
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Jose
J
Nativi-Nicolau
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
Joseph J
JJ
Maleszewski
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
Jennifer R
JR
Geske
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
Walter K
WK
Kremers
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Brooks S
BS
Edwards
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Sudhir S
SS
Kushwaha
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: Pereira.Naveen@mayo.edu.
Naveen L
NL
Pereira
D000328:Adult; D000368:Aged; D001798:Blood Proteins; D017079:Exercise Tolerance; D005260:Female; D005355:Fibrosis; D037502:Galectin 3 / Q000378:metabolism*; D037161:Galectins; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications / Q000378:metabolism*
D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
exercise capacity; galectin-3; heart failure; heart transplantation