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- Title
Galectin-3 in patients with heart failure with preserved ejection fraction: results from the Aldo- DHF trial.
- Authors
Edelmann, Frank; Holzendorf, Volker; Wachter, Rolf; Nolte, Kathleen; Schmidt, Albrecht G.; Kraigher‐Krainer, Elisabeth; Duvinage, André; Unkelbach, Ines; Düngen, Hans‐Dirk; Tschöpe, Carsten; Herrmann‐Lingen, Christoph; Halle, Martin; Hasenfuss, Gerd; Gelbrich, Götz; Stough, Wendy Gattis; Pieske, Burkert M.
- Abstract
Aims Galectin-3 is a marker of myocardial fibrosis and mediates aldosterone-induced cardiovascular inflammation and fibrosis. Characteristics of galectin-3 and its response to spironolactone have not been evaluated in heart failure with preserved ejection fraction ( HFpEF). The aim of this study was to determine the association between galectin-3 levels and patient characteristics in HFpEF; to evaluate the interaction between spironolactone and galectin-3 levels; and to assess the association between galectin-3 and clinical outcomes. Methods and results Aldo- DHF investigated spironolactone 25 mg once daily vs. placebo for 12 months in patients with NYHA class II-III, LVEF ≥50%, grade ≥ I diastolic dysfunction, and peakVO2 ≤ 25 mL/kg/min. Galectin-3 levels were obtained at baseline, and at 6 and 12 months. The association between baseline galectin-3, change in galectin-3, and all-cause death or hospitalization was evaluated, and the interaction between galectin-3 and treatment was assessed. Median baseline galectin-3 was 12.1 ng/ mL. After multivariable adjustment, baseline galectin-3 inversely correlated with peak VO2 ( P = 0.021), 6 min walk distance ( P = 0.002), and Short Form 36 ( SF-36) physical functioning ( P = 0.001), and directly correlated with NYHA class ( P = 0.007). Baseline NT-proBNP correlated with E/e' velocity ratio ( P ≤ 0.001), left atrial volume index ( P < 0.001), and LV mass index ( P = 0.009). Increasing galectin-3 at 6 or 12 months was associated with all-cause death or hospitalization independent of treatment arm [hazard ratio ( HR) 3.319, 95% confidence interval ( CI) 1.214-9.07, P = 0.019] and NT-proBNP ( HR 3.127, 95% CI 1.144-8.549, P = 0.026). Spironolactone did not influence galectin-3 levels. Conclusion Galectin-3 levels are modestly elevated in patients with stable HFpEF and relate to functional performance and quality of life. Increasing galectin-3 was associated with worse outcome, independent of treatment or NT-proBNP.
- Subjects
GALECTINS; HEART failure patients; BIOMARKERS; ALDOSTERONE; FIBROSIS; INFLAMMATION; SPIRONOLACTONE; BRAIN natriuretic factor
- Publication
European Journal of Heart Failure, 2015, Vol 17, Issue 2, p214
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1002/ejhf.203