Abstract 11369: Galectin-3, a Biomarker of Poor Prognosis in Heart Failure Remains Unchanged After Heart Transplantation
Introduction: Galectin (Gal) -3 is a novel biomarker of poor prognosis in patients with heart failure. Elevated Gal-3 levels are associated with advanced heart failure and cardiac fibrosis. The effect of heart transplantation (HTX) on Gal-3 levels and its significance in HTX is unknown.
Methods: Serum Gal-3 levels were measured before and 12 months after HTX in 62 patients who underwent heart (50), heart-kidney (6) and heart-liver (6) TX using an enzyme linked immunosorbent assay. Mean Gal-3 levels were compared before and after TX with a paired t-test. Survival and morbidity events at 12 months were evaluated with regression analysis.
Results: Patients included 47(76%) males, mean age 52 ± 13 years. Indications for TX were dilated 17(27%), ischemic 13(21%), amyloid 8(13%), restrictive 7(11%), hypertrophic 7(11%), congenital 5(8%) and other cardiomyopathies 5(8%). Mean left ventricular ejection fraction increased from 30.2 ± 17.9% before to 61.5 ± 6.4% 12 months after TX. Measured Gal-3 levels before and 12 months after TX are summarized in the Table. Gal-3 levels did not significantly change after TX, although there was a trend for lower Gal-3 levels after heart-kidney TX. Gal-3 levels were elevated (≥17.6 mg/dl) in 36(58%) patients prior to TX and remained elevated in 35(56%) patients after TX. Mean follow-up was 57 ± 30 months and 7 deaths occurred. Amongst all morbidity variables tested at 12 months, increased Gal-3 levels before TX were significantly associated with renal insufficiency (creatinine > 2.0 mg/dl) 12 months after heart-only TX, (odds ratio = 1.14, CI 95%: 1.02-1.27, p = 0.02).
Conclusions: Serum Gal-3 levels remain elevated despite replacement of diseased myocardium and reversal of heart failure state with HTX. These findings suggest that Gal-3 is a systemic biomarker rather than being heart failure specific. Elevated Gal-3 levels pre-TX are associated with renal insufficiency post-TX.
- © 2012 by American Heart Association, Inc.