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.

Abstract

AIMS:

This study was conducted to determine whether galectin-3, a β-galactoside-binding lectin, plays a role in the pathogenesis of heart failure (HF).

METHODS AND RESULTS:

Galectin-3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 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 (P = 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.

CONCLUSIONS:

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.

• Authors: Inder S Anand, Thomas S Rector, Michael Kuskowski, Aram Adourian, Pieter Muntendam, Jay N Cohn
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 15 Issue 5 Pg. 511-8 (May 2013) ISSN: 1879-0844 [Electronic] England
• PMID: 23291728 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Galectin 3
• Tetrazoles
• Valsartan
• Valine

Topics

• Aged
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Cohort Studies
• Double-Blind Method
• Female
• Follow-Up Studies
• Galectin 3 (blood)
• Heart Failure (blood, drug therapy, mortality)
• Hospitalization (statistics & numerical data)
• Humans
• Male
• Middle Aged
• Prognosis
• Proportional Hazards Models
• Risk Factors
• Tetrazoles (therapeutic use)
• Time Factors
• Treatment Outcome
• Valine (analogs & derivatives, therapeutic use)
• Valsartan