Baseline and serial measurements of galectin‐3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val‐HeFT. (May 2013)

• Record Type: Journal Article
• Authors: Anand, Inder S.; Rector, Thomas S.; Kuskowski, Michael; Adourian, Aram; Muntendam, Pieter; Cohn, Jay N.
• Is Part Of: European journal of heart failure. Volume 15:Number 5(2013)
• Page Start: 511
• Page End: 518
• Publication Date: 2013-05
• Subjects: Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1093/eurjhf/hfs205
• Languages: English
• ISSNs: 1388-9842

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ejhfhfs205-sec-0001" sec-type="section"> <title>Aims</title> <p>This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF).</p> </sec> <sec id="ejhfhfs205-sec-0002" sec-type="section"> <title>Methods and results</title> <p>Galectin‐3 was measured at baseline (<italic>n</italic> = 1650), after 4 months (<italic>n</italic> = 1346), and after 12 months (<italic>n</italic> = 1097) in the Valsartan Heart Failure Trial (Val‐HeFT). Galectin‐3 levels at baseline ranged from 4.8 to 53 ng/mL. Higher levels were associated with features of worse HF. In a fully adjusted Cox regression model comprising 23 other prognostic variables, baseline galectin‐3 was not associated with the risks of all‐cause mortality, the composite of the first morbid event, or hospitalization for HF. However, when changes in galectin‐3 over time were examined, the increases in galectin‐3 between baseline and 4 months were independently and significantly associated with the risks of subsequent all‐cause mortality, first morbid event, and hospitalizations for HF, even after adjusting for all baseline and concurrent changes in all variables including estimated glomerular filtration rate (eGFR) and NT‐proBNP. The strongest correlate of galectin‐3 levels was eGFR, which accounted for 20% of the variability in galectin‐3 levels at baseline. There was a significant interaction (<italic>P</italic> = 0.03) between baseline galectin‐3 and the effect of valsartan on hospitalizations for HF. Valsartan caused a significant 44% reduction in hospitalizations for HF in patients with galectin‐3 levels below the median level of 16.2 ng/mL, but not in patients with levels above the median.</p> </sec> <sec id="ejhfhfs205-sec-0003" sec-type="section"> <title>Conclusions</title> <p>Galectin‐3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal dysfunction. Galectin‐3 increased over time in this cohort, and the increase was independently associated with worse outcomes. Valsartan use was associated with a reduction in hospitalizations for HF in patients with low galectin‐3, but not in those with higher levels of galectin‐3.</p> </sec> </abstract>