Open AccessGalectin‐3 Is Associated With Stage B Metabolic Heart Disease and Pulmonary Hypertension in Young Obese Patients
Author(s) -
Gopal Deepa M.,
Ayalon Nir,
Wang YiChih,
Siwik Deborah,
Sverdlov Aaron,
Donohue Courtney,
Perez Alejandro,
Downing Jill,
Apovian Caroline,
Silva Vanessa,
Panagia Marcello,
Kolachalama Vijaya,
Ho Jennifer E.,
Liang Changseng,
Gokce Noyan,
Colucci Wilson S.
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.011100
Subject(s) - medicine , cardiology , heart failure , ejection fraction , asymptomatic , left ventricular hypertrophy , pulmonary hypertension , natriuretic peptide , blood pressure
Background Obesity is a precursor to heart failure with preserved ejection fraction. Biomarkers that identify preclinical metabolic heart disease ( MHD ) in young obese patients would help identify high‐risk individuals for heart failure prevention strategies. We assessed the predictive value of GAL3 (galectin–3), FSTL3 (follistatin‐like 3 peptide), and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) to identify stage B MHD in young obese participants free of clinically evident cardiovascular disease. Methods and Results Asymptomatic obese patients (n=250) and non‐obese controls (n=21) underwent echocardiographic cardiac phenotyping. Obese patients were classified as MHD positive ( MHD ‐ POS ; n=94) if they had abnormal diastolic function or left ventricular hypertrophy and had estimated pulmonary artery systolic pressure ≥35 mm Hg. Obese patients without such abnormalities were classified as MHD negative (MHD‐NEG; n=52). Serum biomarkers timed with echocardiography. MHD ‐ POS and MHD‐NEG individuals were similarly obese, but MHD ‐ POS patients were older, with more diabetes mellitus and metabolic syndrome. Right ventricular coupling was worse in MHD ‐ POS patients ( P <0.001). GAL 3 levels were higher in MHD ‐ POS versus MHD ‐NEG patients (7.7±2.3 versus 6.3±1.9 ng/mL, respectively; P <0.001). Both GAL 3 and FSTL 3 levels correlated with diastolic dysfunction and increased pulmonary artery systolic pressure but not with left ventricular mass. In multivariate models including all 3 biomarkers, only GAL 3 remained associated with MHD (odds ratio: 1.30; 95% CI , 1.01–1.68; P =0.04). Conclusions In young obese individuals without known cardiovascular disease, GAL 3 is associated with the presence of preclinical MHD . GAL 3 may be useful in screening for preclinical MHD and identifying individuals with increased risk of progression to obesity‐related heart failure with preserved ejection fraction.