Circulating Galectin-3 Levels Are Persistently Elevated After Heart Transplantation and Are Associated With Renal Dysfunction

JACC Heart Fail. 2016 Nov;4(11):847-856. doi: 10.1016/j.jchf.2016.06.010. Epub 2016 Sep 7.

Abstract

Objectives: This study evaluated changes in serum levels of galectin (Gal)-3 before and after heart transplantation (HTx) and assessed the role of pre-HTx Gal-3 as a biomarker for post-HTx outcomes.

Background: Gal-3 is a novel biomarker that reflects cardiac remodeling and fibrosis. Elevated serum Gal-3 levels are associated with poor prognosis in heart failure patients. Whether Gal-3 levels change following HTx and the significance of post-HTx outcomes are unknown.

Methods: Serum Gal-3 levels were measured in 62 patients at 118 days (Interquartile Range [IQR]: 23 to 798 days) before and 365 days (IQR: 54 to 767 days) post HTx. Cardiac tissue taken during routine post-HTx endomyocardial biopsy was evaluated to assess the correlation between tissue Gal-3 staining and serum Gal-3 levels and with the presence of myocardial hypertrophy and fibrosis.

Results: Serum Gal-3 levels remained significantly elevated (>17.8 ng/ml) in 35 patients (56%) post HTx. There was a significant inverse correlation between Gal-3 levels and glomerular filtration rate measured before and after HTx (p > 0.005). There was no association between Gal-3 serum level and Gal-3 staining of myocardial tissue or with the presence of myocyte hypertrophy and interstitial fibrosis post HTx. Elevated pre-HTx Gal-3 levels were associated with reduced post-HTx exercise capacity, but this association was not significant after adjustment for age, body mass index, and glomerular filtration rate.

Conclusions: This is the first study to demonstrate the fact that Gal-3 levels remain elevated in the majority of patients despite HTx and is associated with renal dysfunction. Our findings suggest Gal-3 is a systemic rather than cardiac-specific biomarker.

Keywords: exercise capacity; galectin-3; heart failure; heart transplantation.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Blood Proteins
  • Exercise Tolerance
  • Female
  • Fibrosis
  • Galectin 3 / metabolism*
  • Galectins
  • Glomerular Filtration Rate
  • Heart Failure / complications
  • Heart Failure / metabolism
  • Heart Failure / surgery*
  • Heart Transplantation*
  • Humans
  • Hypertrophy
  • Male
  • Middle Aged
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Prognosis
  • Renal Insufficiency / complications
  • Renal Insufficiency / metabolism*

Substances

  • Blood Proteins
  • Galectin 3
  • Galectins
  • LGALS3 protein, human