title: Plasma and Cardiac Galectin-3 in Patients With Heart Failure Reflects Both Inflammation and Fibrosis: Implications for Its Use as a Biomarker.
abstract: BACKGROUND
  Galectin (Gal)-3 is a β-galactoside-binding lectin and currently intensely studied as a biomarker in heart failure. Gal-3 also exerts proinflammatory effects, at least in extracardiac tissues. Objective of this study was to characterize the relationship of plasma and myocardial Gal-3 levels with cardiac fibrosis and inflammation in patients with nonischemic dilated cardiomyopathy and inflammatory cardiomyopathy (iCMP).
  
  
  RESULTS
  Endomyocardial biopsies and blood samples were obtained from patients with newly diagnosed cardiomyopathy and clinical suspicion of myocarditis. According to histopathologic findings, patients were classified as having dilated cardiomyopathy (n=40) or iCMP (n=75). Cardiac fibrosis was assessed histologically on endomyocardial biopsy sections. In patients with iCMP, myocardial Gal-3 expression significantly correlated with inflammatory cell count on endomyocardial biopsy (r=0.56;P<0.05). In contrast, an inverse association was observed between myocardial Gal-3 expression and cardiac fibrosis in patients with iCMP (r=-0.59;P<0.05). In patients with dilated cardiomyopathy, myocardial Gal-3 expression correlated with cardiac fibrosis on left ventricular biopsy (P=0.63;P<0.01). Of note, in both groups, plasma Gal-3 levels did not correlate with myocardial Gal-3 levels or left ventricular fibrosis, whereas a positive correlation between plasma Gal-3 levels and inflammatory cell count on endomyocardial biopsy was observed in patients with iCMP.
  
  
  CONCLUSIONS
  The present study suggests that myocardial Gal-3 can be considered as a possible marker for both cardiac inflammation and fibrosis, depending on the pathogenesis of heart failure. However, circulating concentrations of Gal-3 do not seem to reflect endomyocardial Gal-3 levels or cardiac fibrosis.
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Christian
authors.initials: C
authors.lastname: Besler
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: David
authors.initials: D
authors.lastname: Lang
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Urban
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Karl-Philipp
authors.initials: KP
authors.lastname: Rommel
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Maximilian
authors.initials: M
authors.lastname: von Roeder
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Karl
authors.initials: K
authors.lastname: Fengler
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Stephan
authors.initials: S
authors.lastname: Blazek
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kandolf
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Karin
authors.initials: K
authors.lastname: Klingel
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.).
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.affiliation: From the Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Germany (C.B., D.L., D.U., K.-P.R., M.v.R., K.F., S.B., A.L., G.S., V.A., P.L.); Institute for Pathology and Neuropathology, Department of Molecular Pathology, University Hospital Tübingen, Germany (R.K., K.K.); and Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Germany (H.T.). Philipp.Lurz@gmx.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lurz
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001798:Blood Proteins; D009202:Cardiomyopathies / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D005260:Female; D005355:Fibrosis; D037502:Galectin 3 / Q000097:blood* / Q000235:genetics; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D009206:Myocardium / Q000737:chemistry* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D012333:RNA, Messenger
keywords: biomarker; fibrosis; galectin-3; heart failure; inflammation; inflammatory cardiomyopathy