Abstract 17018: Plasma Concentrations of Galectin-3 in Patients with Suspected and Confirmed Heart Failure: Distribution, Associations and Prognostic Significance
Background: Plasma concentrations of galectin-3 predict outcome in patients with acute heart failure but have not been studied in a large epidemiologically-representative out-patient population.
Aims: To explore the distribution, associations and prognostic significance of plasma concentrations of galectin-3 in patients with suspected heart failure of varied phenotypes.
Methods: Patients referred to a heart failure clinic from the local population were invited to participate. Symptoms, signs and routine investigations, including spirometry, electro- and echo-cardiograms and blood tests, including NT-proBNP were systematically recorded. Patients were followed for four or more years.
Results: Of 1,047 patients evaluated, 403 had no structural heart disease on echo, 508 had left ventricular (LV) systolic dysfunction, 76 had substantial valve disease and 108 had evidence only of ‘diastolic’ LV dysfunction. Plasma galectin-3 ranged (median IQR) from 14.8 (11.0 to 18.3)ng/ml in patients without overt disease to 19.5 (15.1-24.6)ng/ml in patients with LV systolic dysfunction and elevated NT-proBNP. Greater age, serum creatinine and white blood cell count, lower systolic blood pressure and female sex, but not LV function, predicted plasma galectin-3 but explained little of its variability (R2 = 0.0300; p<0.0001). During follow-up, 266 patients (25%) died, of which 145 were primarily for cardiovascular reasons. On univariate analysis and after correction for age and sex differences, the plasma concentration of galectin-3 was a strong predictor of all-cause mortality.
Conclusions: Plasma galectin-3 is commonly increased in patients with heart failure but appears better related to renal function and NT-proBNP than LV ejection fraction. Plasma galectin-3 is strongly related to an adverse prognosis, which may be due, in part, to its relationship to renal function. Whether galectin-3 is a marker or mediator of cardiac and renal dysfunction remains to be determined.
- © 2011 by American Heart Association, Inc.