title: Galectin-3 and fibulin-1 in systolic heart failure - relation to glucose metabolism and left ventricular contractile reserve.
abstract: Heart failure (HF) patients with diabetes (DM) have an adverse prognosis and reduced functional capacity, which could be associated with cardiac fibrosis, increased chamber stiffness and reduced left ventricular (LV) contractile reserve. Galectin-3 (Gal-3) and fibulin-1 are circulating biomarkers potentially reflecting cardiac fibrosis. We hypothesize that plasma levels of Gal-3 and fibulin-1 are elevated in HF patients with DM and are associated with reduced LV contractile reserve in these patients.
  
  
  
  A total of 155 patients with HF with reduced ejection fraction underwent a low-dose dobutamine echocardiography and blood sampling for biomarker measurements. Patients were classified according to history of DM and an oral glucose tolerance test (OGTT) as: normal glucose tolerance (NGT) (n = 70), impaired glucose tolerance (IGT) (n = 25) and DM (n = 60).
  
  
  
  Galectin-3 levels were elevated in DM patients as compared to non-diabetic patients (P = 0.02), while higher fibulin-1 levels were observed in HF patients with IGF and DM (P = 0.07). Reduced LV contractile reserve was associated with increasing Gal-3 levels (β = -0.19, P = 0.03) although, this association was attenuated after adjustment for estimated glomerular filtration rate (P = 0.66). Fibulin-1 was not associated with LV contractile reserve (P = 0.71).
  
  
  
  Galectin-3 and fibulin-1 levels were elevated in HF patients with impaired glucose metabolism. However, reduced LV contractile reserve among HF patients with DM does not to have an independent impact on plasma Gal-3 and fibulin-1 levels.
authors.affiliation: Department of Medicine, Endocrine Unit, Herlev University Hospital, Herlev, Denmark. holmager@dadlnet.dk.|Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark. holmager@dadlnet.dk.|Department of Endocrinology, Herlev Hospital, Herlev, Denmark. holmager@dadlnet.dk.
authors.forename: Pernille
authors.initials: P
authors.lastname: Holmager
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Egstrup
authors.affiliation: Department of Cardiology, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Ida
authors.initials: I
authors.lastname: Gustafsson
authors.affiliation: Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.|Department of Cardiology, Herlev University Hospital, Herlev, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark.
authors.forename: Jordi S
authors.initials: JS
authors.lastname: Dahl
authors.affiliation: Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.|Centre of Individualized Medicine in Arterial Diseases, Odense University Hospital, Odense, Denmark.
authors.forename: Lars Melholt
authors.initials: LM
authors.lastname: Rasmussen
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Møller
authors.affiliation: Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Tuxen
authors.affiliation: Department of Medicine, Endocrine Unit, Herlev University Hospital, Herlev, Denmark.|Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.affiliation: Department of Medicine, Endocrine Unit, Herlev University Hospital, Herlev, Denmark.|Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
mesh_terms: D058665:Adrenergic beta-1 Receptor Agonists / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001798:Blood Proteins; D002135:Calcium-Binding Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis; D004280:Dobutamine / Q000008:administration & dosage; D025401:Echocardiography, Stress / Q000379:methods; D005260:Female; D005355:Fibrosis; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D054143:Heart Failure, Systolic / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D058665:Adrenergic beta-1 Receptor Agonists; D015415:Biomarkers; D001786:Blood Glucose; D001798:Blood Proteins; D002135:Calcium-Binding Proteins; D004280:Dobutamine; D037502:Galectin 3; D037161:Galectins; D006442:Glycated Hemoglobin; C428445:LGALS3 protein, human; C060820:fibulin; C517652:hemoglobin A1c protein, human
keywords: Diabetes; Fibulin-1; Galectin-3; Left ventricular contractile reserve; Myocardial fibrosis