ISSN 2996-8215
International Journal of Cardiology | Vol. 2, No. 10, October 2011 | pp. 73–80
DOI: 10.46882/2011/IJC/000031
Original Research Article
Prognostic Value of Galectin-3 in Acute Decompensated Heart Failure Patients with Preserved versus Reduced Ejection Fraction
Stefan de Vries¹, Anika Janssen¹, Maarten van der Meer²
¹Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
²Division of Cardiovascular Medicine, University Medical Center Utrecht, Utrecht, Netherlands
Abstract:
Galectin-3 is a soluble beta-galactoside-binding lectin implicated in myocardial fibrosis and remodeling. This study sought to evaluate the prognostic value of plasma Galectin-3 levels in patients admitted for acute decompensated heart failure (ADHF), comparing those with preserved ejection fraction (HFpEF) versus reduced ejection fraction (HFrEF). We prospectively enrolled 280 patients hospitalized with ADHF. Patients were classified into HFrEF (LVEF less than 40%, n = 155) or HFpEF (LVEF greater than or equal to 50%, n = 125). Plasma Galectin-3 was measured at admission. The primary endpoint was a composite of 12-month all-cause mortality or heart failure readmission. Baseline Galectin-3 concentrations were significantly higher in HFpEF patients than in HFrEF patients (21.4 ± 6.8 ng/mL vs. 17.6 ± 5.2 ng/mL, p < 0.01). At 12 months, the primary endpoint occurred in 84 patients (30.0%). High Galectin-3 (greater than 17.8 ng/mL) was associated with a significantly higher event rate in both cohorts. However, multivariable Cox proportional hazards analysis revealed that Galectin-3 was an independent predictor of the composite endpoint specifically in the HFpEF cohort (hazard ratio: 1.84, 95% CI: 1.24–2.72, p = 0.002), whereas its independent predictive value dropped after adjusting for eGFR and NT-proBNP in the HFrEF cohort (hazard ratio: 1.21, 95% CI: 0.91–1.62, p = 0.18). Elevated admission Galectin-3 levels are associated with poor 12-month outcomes in ADHF, demonstrating a stronger, independent prognostic utility in patients with preserved ejection fraction than in those with reduced ejection fraction.
Keywords: Acute decompensated heart failure, Galectin-3, Heart failure with preserved ejection fraction, Heart failure with reduced ejection fraction, Biomarkers, Prognosis
Received: July 02, 2011; Revised: August 14, 2011; Accepted: September 05, 2011; Published: October 18, 2011
Citation: International Journal of Cardiology, 2011, Vol. 2, No. 10, pp. 73–80, DOI: 10.46882/2011/IJC/000031