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Galectin‐3, cardiac structure and function, and long‐term mortality in patients with acutely decompensated heart failure
Author(s) -
Shah Ravi V.,
ChenTournoux Annabel A.,
Picard Michael H.,
Kimmenade Roland R. J.,
Januzzi James L.
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq091
Subject(s) - medicine , cardiology , heart failure , acute decompensated heart failure , galectin 3 , proportional hazards model , creatinine , renal function , doppler imaging , blood pressure , diastole
Aims To determine the relationship between galectin‐3 concentrations and cardiac structure in patients with acute dyspnoea, and to evaluate the impact of galectin‐3 independent of echocardiographic measurements on long‐term mortality. Methods and results One hundred and fifteen patients presenting to the emergency department with acute dyspnoea who had galectin‐3 levels and detailed echocardiographic studies on admission were studied. Galectin‐3 levels were associated with older age ( r = 0.26, P = 0.006), lower creatinine clearance ( r = −0.42, P < 0.001), and higher levels of N‐terminal‐proBNP ( r = 0.39, P < 0.001). Higher galectin‐3 levels were associated with tissue Doppler E / E a ratio ( r = 0.35, P = 0.01), a lower right ventricular (RV) fractional area change ( r = −0.19, P = 0.05), higher RV systolic pressure ( r = 0.37, P < 0.001), and more severe mitral ( r = 0.30, P = 0.001) or tricuspid regurgitation ( r = 0.26, P = 0.005). In patients diagnosed with heart failure (HF), the association between galectin‐3 and valvular regurgitation and RV systolic pressure persisted. In a multivariate Cox regression model, galectin‐3 remained a significant predictor of 4‐year mortality independent of echocardiographic markers of risk. Dyspnoeic patients with HF and galectin‐3 levels above the median value had a 63% mortality; patients less than the median value had a 37% mortality ( P = 0.003). Conclusion Among dyspnoeic patients with and without ADHF, galectin‐3 concentrations are associated with echocardiographic markers of ventricular function. In patients with ADHF, a single admission galectin‐3 level predicts mortality to 4 years, independent of echocardiographic markers of disease severity.