Purpose
Galectin-3 (gal-3) is a novel biomarker implicated in cardiac fibrosis and is shown to correlate with the severity of heart failure (HF) and to independently predict mortality in HF. We investigated if hemodynamic improvement after left ventricular assist device (LVAD) implantation affects gal-3 levels.
Methods and Materials
Plasma samples were acquired from patients at time of LVAD implantation (HMII or Heartware, n=57), at 3 (n=17) and 6 months post-LVAD (n=14), and at explantation (n=23), as well as from healthy age and gender matched controls (n=30). Gal-3 was measured using a commercially available ELISA assay (BG Medicine, Waltham, MA). Data was analyzed with Prism 5. Events rates were calculated using the Kaplan-Meier method.
Results
At time of LVAD implantation, HF patients had significantly higher gal-3 levels compared to controls (29.2±14 ng/ml vs. 13±9 ng/ml; p<0.0001). Mechanical unloading led to improvement in echocardiographic parameters (LVEDD: 6.1±1 cm vs. 6.7±1 cm pre-LVAD; p=0.04 and LA diameter: 4.4±1 cm vs. 5±1 cm pre-LVAD; p=0.002). Gal-3 levels numerically decreased at 3 (23.7±9 ng/ml; p=0.33) and 6 months (21.7±9 ng/ml; p=0.18) post LVAD. At explantation (mean duration 249±209 days), gal-3 levels were significantly higher than at implantation (40.4±19 ng/ml vs. 29.2±14 ng/ml; p=0.005). Pre-implantation gal-3 levels predicted survival in patients on LVAD support (dichotomized at cut-off 30 ng/ml; log rank p=0.03). [figure 1]
Conclusions
Gal-3 levels are associated with HF state and predict survival on LVAD support. Distinct dynamics in gal-3 levels occur in patients following LVAD implantation with an initial decrease but subsequent increase. Gal-3 may serve as a new biomarker for risk assessment of patients before LVAD implantation.
Article info
Identification
Copyright
© 2013 Published by Elsevier Inc.
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