Dynamics and prognostic role of galectin-3 in patients with advanced heart failure, during left ventricular assist device support and following heart transplantation

作者：Coromilas Ellie; Que Xu Em Claire; Moore D'Vesharronne; Kato Tomoko S; Wu Christina; Ji Ruiping; Givens Raymond; Jorde Ulrich P; Takayama Hiroo; Naka Yoshifumi; George Isaac; Mancini Donna; Schulze P Christian^*

来源：BMC Cardiovascular Disorders, 2016, 16(1): 138.

DOI：10.1186/s12872-016-0298-z

• Heart Failure
• Galectin-3
• LVAD
• Heart Transplantation
• Coronary Allograft Vasculopathy

Background: 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.
Methods: 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).
Results: 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).
Conclusions: 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.

• 出版日期2016-6-14