Plasma and Cardiac Galectin-3 in Patients With Heart Failure Reflects Both Inflammation and Fibrosis: Implications for Its Use as a Biomarker

Circ Heart Fail. 2017 Mar;10(3):e003804. doi: 10.1161/CIRCHEARTFAILURE.116.003804.

Abstract

Background: Galectin (Gal)-3 is a β-galactoside-binding lectin and currently intensely studied as a biomarker in heart failure. Gal-3 also exerts proinflammatory effects, at least in extracardiac tissues. Objective of this study was to characterize the relationship of plasma and myocardial Gal-3 levels with cardiac fibrosis and inflammation in patients with nonischemic dilated cardiomyopathy and inflammatory cardiomyopathy (iCMP).

Methods and results: Endomyocardial biopsies and blood samples were obtained from patients with newly diagnosed cardiomyopathy and clinical suspicion of myocarditis. According to histopathologic findings, patients were classified as having dilated cardiomyopathy (n=40) or iCMP (n=75). Cardiac fibrosis was assessed histologically on endomyocardial biopsy sections. In patients with iCMP, myocardial Gal-3 expression significantly correlated with inflammatory cell count on endomyocardial biopsy (r=0.56; P<0.05). In contrast, an inverse association was observed between myocardial Gal-3 expression and cardiac fibrosis in patients with iCMP (r=-0.59; P<0.05). In patients with dilated cardiomyopathy, myocardial Gal-3 expression correlated with cardiac fibrosis on left ventricular biopsy (P=0.63; P<0.01). Of note, in both groups, plasma Gal-3 levels did not correlate with myocardial Gal-3 levels or left ventricular fibrosis, whereas a positive correlation between plasma Gal-3 levels and inflammatory cell count on endomyocardial biopsy was observed in patients with iCMP.

Conclusions: The present study suggests that myocardial Gal-3 can be considered as a possible marker for both cardiac inflammation and fibrosis, depending on the pathogenesis of heart failure. However, circulating concentrations of Gal-3 do not seem to reflect endomyocardial Gal-3 levels or cardiac fibrosis.

Keywords: biomarker; fibrosis; galectin-3; heart failure; inflammation; inflammatory cardiomyopathy.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biopsy
  • Blood Proteins
  • Cardiomyopathies / blood*
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / genetics
  • Female
  • Fibrosis
  • Galectin 3 / blood*
  • Galectin 3 / genetics
  • Galectins
  • Heart Failure / blood*
  • Heart Failure / diagnosis
  • Heart Failure / genetics
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Myocarditis / blood*
  • Myocarditis / diagnosis
  • Myocarditis / genetics
  • Myocardium / chemistry*
  • Myocardium / pathology
  • Predictive Value of Tests
  • Prospective Studies
  • RNA, Messenger / genetics
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • Biomarkers
  • Blood Proteins
  • Galectin 3
  • Galectins
  • LGALS3 protein, human
  • RNA, Messenger