1
|
van den Berg PF, Aboumsallem JP, Screever EM, Shi C, de Wit S, Bracun V, Yousif LI, Geerlings L, Wang D, Ho JE, Bakker SJ, van der Vegt B, Silljé HH, de Boer RA, Meijers WC. Fibrotic Marker Galectin-3 Identifies Males at Risk of Developing Cancer and Heart Failure. JACC CardioOncol 2023; 5:445-453. [PMID: 37614579 PMCID: PMC10443113 DOI: 10.1016/j.jaccao.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 08/25/2023] Open
Abstract
Background Cancer and heart failure (HF) are the leading causes of death in the Western world. Shared mechanisms such as fibrosis may underlie either disease entity, furthermore it is unknown whether this relationship is sex-specific. Objectives We sought to investigate how fibrosis-related biomarker galectin-3 (gal-3) aids in identifying individuals at risk for new-onset cancer and HF, and how this differs between sexes. Methods Gal-3 was measured at baseline and at 4-year follow-up in 5,786 patients of the PREVEND (Prevention of Renal and Vascular Endstage Disease) study. The total follow-up period was 11.5 years. An increase of ≥50% in gal-3 levels between measurements was considered relevant. We performed sex-stratified log-rank tests and Cox regression analyses overall and by sex to evaluate the association of gal-3 over time with both new-onset cancer and new-onset HF. Results Of the 5,786 healthy participants (50% males), 399 (59% males) developed new-onset cancer, and 192 (65% males) developed new-onset HF. In males, an increase in gal-3 was significantly associated with new-onset cancer (both combined and certain cancer-specific subtypes), after adjusting for age, body mass index, hypertension, smoking status, estimated glomerular filtration rate, diabetes mellitus, triglycerides, coronary artery disease, and C-reactive protein (HR: 1.89; 95% CI: 1.32-2.71; P < 0.001). Similar analyses demonstrated an association with new-onset HF in males (HR: 1.77; 95% CI: 1.07-2.95; P = 0.028). In females, changes in gal-3 over time were neither associated with new-onset cancer nor new-onset HF. Conclusions Gal-3, a marker of fibrosis, is associated with new-onset cancer and new-onset HF in males, but not in females.
Collapse
Affiliation(s)
- Pieter F. van den Berg
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Joseph Pierre Aboumsallem
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Elles M. Screever
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Canxia Shi
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sanne de Wit
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Valentina Bracun
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Laura I. Yousif
- Department of Cardiology, Thorax Center, Erasmus Medical center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Lotte Geerlings
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dongyu Wang
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jennifer E. Ho
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Stephan J.L. Bakker
- Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Herman H.W. Silljé
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rudolf A. de Boer
- Department of Cardiology, Thorax Center, Erasmus Medical center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wouter C. Meijers
- Department of Experimental Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Cardiology, Thorax Center, Erasmus Medical center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Screever EM, Gorter TM, Willems TP, Aboumsallem JP, Suthahar N, Mahmoud B, van Veldhuisen DJ, de Boer RA, Meijers WC. Diffuse Myocardial Fibrosis on Cardiac Magnetic Resonance Imaging Is Related to Galectin-3 and Predicts Outcome in Heart Failure. Biomolecules 2023; 13:410. [PMID: 36979345 PMCID: PMC10046101 DOI: 10.3390/biom13030410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
AIMS Ongoing adverse remodeling is a hallmark of heart failure (HF), which might be reflected by either focal or diffuse myocardial fibrosis. Therefore, in (pre)clinical settings, we used immunohistochemistry or cardiac magnetic resonance imaging (CMR) to investigate the association of (focal or diffuse) fibrosis with cardiac biomarkers and adverse events in HF. METHODS AND RESULTS In C57Bl/6J mice, we determined the presence and extent of myocardial fibrosis 6 weeks post-myocardial infarction (MI). Furthermore, we studied 159 outpatient HF patients who underwent CMR, and determined focal and diffuse fibrosis by late gadolinium enhancement (LGE) and post-contrast T1 time of the non-LGE myocardium, respectively. HF patients were categorized based on the presence of LGE, and by the median post-contrast T1 time. Kaplan-Meier and Cox regression analyses were used to determine the association of fibrosis with HF hospitalization and all-cause mortality. LGE was detected in 61 (38%) patients. Cardiac biomarker levels were comparable between LGE-positive and LGE-negative patients. LGE-positive patients with a short T1 time had elevated levels of both NT-proBNP and galectin-3 (1611 vs. 453 ng/L, p = 0.026 and 20 vs. 15 μg/L, p = 0.004, respectively). This was not observed in LGE-negative patients. Furthermore, a short T1 time in LGE-positive patients was associated with a higher risk of adverse events (log-rank p = 0.01). CONCLUSION This study implies that cardiac biomarkers reflect active remodeling of the non-infarcted myocardium of patients with focal myocardial scarring. Diffuse fibrosis, in contrast to focal scarring, might have a higher prognostic value regarding adverse outcomes in HF patients.
Collapse
Affiliation(s)
- Elles M. Screever
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Thomas M. Gorter
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Tineke P. Willems
- Department of Radiology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Joseph Pierre Aboumsallem
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Navin Suthahar
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Belend Mahmoud
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Dirk J. van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Rudolf A. de Boer
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Wouter C. Meijers
- Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
3
|
Badianyama M, Mpanya D, Adamu U, Sigauke F, Nel S, Tsabedze N. New Biomarkers and Their Potential Role in Heart Failure Treatment Optimisation-An African Perspective. J Cardiovasc Dev Dis 2022; 9:jcdd9100335. [PMID: 36286287 PMCID: PMC9604249 DOI: 10.3390/jcdd9100335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Heart failure is a clinical syndrome resulting from various cardiovascular diseases of different aetiologies and pathophysiology. These varying pathologies involve several complex mechanisms that lead to the activation of the neurohumoral system, inflammation, angiogenesis, apoptosis, fibrosis, and eventually adverse cardiac remodelling associated with a progressive decline in cardiac function. Once a diagnosis is made, the cardiac function has a gradual decline characterised by multiple hospital admissions. It is therefore imperative to identify patients at different stages of the heart failure continuum to better risk stratify and initiate optimal management strategies. Biomarkers may play a role in the diagnosis, prognostication, and monitoring response to treatment. This review discusses the epidemiology of heart failure and biomarkers commonly used in clinical practice such as natriuretic peptides and cardiac troponins. In addition, we provide a brief overview of novel biomarkers and genetic coding and non-coding biomarkers used in the management of patients with heart failure. We also discuss barriers that hinder the clinical application of novel biomarkers. Finally, we appraise the value of polygenic risk scoring, focusing on sub-Saharan Africa.
Collapse
|
4
|
Jiang J, Yang B, Sun Y, Jin J, Zhao Z, Chen S. Diagnostic Value of Serum Concentration of Galectin-3 in Patients With Heart Failure With Preserved Ejection Fraction. Front Cardiovasc Med 2022; 8:829151. [PMID: 35141299 PMCID: PMC8818801 DOI: 10.3389/fcvm.2021.829151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 12/20/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although the predictive value of galectin-3 for heart failure with preserved ejection fraction has been demonstrated, the diagnostic value remains unclear. The present study was performed to address this issue. HYPOTHESIS Galectin-3 has diagnostic value for heart failure with preserved ejection fraction. METHODS This is a diagnostic experiment. We conducted an observational study of 223 patients with combined symptoms of heart failure and diseases that can lead to heart failure with preserved ejection fraction. Patients were grouped into the heart failure group and control group in accordance with the 2016 European Society of Cardiology heart failure guidelines for heart failure with preserved ejection fraction. Baseline information and serum galectin-3 concentration were assessed within 24 h after admission. RESULTS Serum galectin-3 concentration was significantly higher in the heart failure group compared with the control group. Binary logistic regression analysis showed that higher galectin-3 concentration was associated with the occurrence of heart failure with preserved ejection fraction. The area under the curve of galectin-3 was 0.763, indicating that galectin-3 has moderate diagnostic value for heart failure with preserved ejection fraction. Galectin-3 >15.974 ng/mL identified heart failure with preserved ejection fraction with 76.0% sensitivity and 71.9% specificity. CONCLUSIONS There was a correlation between galectin-3 and heart failure with preserved ejection fraction, and galectin-3 was an independent predictor of heart failure with preserved ejection fraction. The diagnostic value of galectin-3 for heart failure with preserved ejection fraction was moderate (AUC: 0.763, 95% CI: 0.696-0.821, P < 0.01, and the sensitivity is 76.0% while the specificity is 71.9% at the threshold 15.974 ng/mL) and was higher than that of interventricular septal thickness or E/A ratio.
Collapse
Affiliation(s)
- Jing Jiang
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Baojun Yang
- Department of Cardiology, First Affiliated Hospital, Shantou University Medical College, Shantou, China
| | - Ying Sun
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Jin
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiying Zhao
- Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Songming Chen
- Department of Cardiology, First Affiliated Hospital, Shantou University Medical College, Shantou, China
| |
Collapse
|
5
|
Lebedev DA, Lyasnikova EA, Vasilyeva EY, Likhonosov NP, Sitnikova MY, Babenko AY. Association between Markers of Fibrosis and Heart Failure Incidence in Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2021; 2021:9589185. [PMID: 34778465 PMCID: PMC8589473 DOI: 10.1155/2021/9589185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/05/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) and chronic heart failure (HF) have close association, and several biomarkers have been studied to better understand this association and improve prediction of HF in T2DM. Furthermore, in recent clinical trials, sodium glucose cotransporter 2 inhibitors (SGLT2i), glucose-lowering drugs, improved HF outcomes. The objective of the present study was to evaluate association between circulating biomarkers of fibrosis and incidence of HF with preserved ejection fraction (HFpEF) in patients with T2DM receiving sodium glucose cotransporter 2 inhibitors (SGLT2i). Materials and Methods. At baseline, transthoracic echocardiography and laboratory assessment of N-terminal fragment of the brain natriuretic peptide (Nt-proBNP), soluble suppression of tumorigenesis-2 (sST2), galectin-3 (Gal-3), C-terminal propeptide of procollagen type I (PICP), N-terminal propeptide of procollagen type III (PIIINP), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix proteinase-1 (TIMP-1) were done. After 3 years of follow-up, information about HF events (hospitalization for HF, established HF in outpatient department by a cardiologist) was obtained. Results. Seventy-two patients were included in the study. The mean age was 57 (49.7; 63.2) years; 44% were female. Most patients had T2DM for more than 4 years. All patients were overweight or had obesity, and 93% patients had arterial hypertension (AH). After 3 years of follow-up, HFpEF was established in 21% patients. Patients were divided into two groups according to the presence of HFpEF, and baseline characteristics were compared. Patients with HF were older and had longer diabetes and AH duration and higher Nt-proBNP, Gal-3, PIIINP, and PICP levels at baseline than patients without HF (all p < 0.05). Gal - 3 > 10 ng/ml (OR = 2.25; 95% CI, 1.88-5.66; p = 0.01) and NT - pro - BNP > 80 pg/ml (OR = 2.64; 95% CI, 1.56-4.44; p = 0.001) were associated with increased risk of HF incidence. Age > 60 years, diabetes duration > 10 years, and presence of abdominal obesity were independent predictors of HFpEF as well. Conclusions. T2DM patients treated with SLGT2i, who developed HFpEF after 3 years of follow-up, had higher PICP, PIIINP, Gal-3, and NT-proBNP serum concentrations at baseline, and Gal-3 level was an independent predictor of HFpEF.
Collapse
Affiliation(s)
- Denis A. Lebedev
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | | | | | | | | |
Collapse
|
6
|
Meijers WC, Bayes-Genis A, Mebazaa A, Bauersachs J, Cleland JGF, Coats AJS, Januzzi JL, Maisel AS, McDonald K, Mueller T, Richards AM, Seferovic P, Mueller C, de Boer RA. Circulating heart failure biomarkers beyond natriuretic peptides: review from the Biomarker Study Group of the Heart Failure Association (HFA), European Society of Cardiology (ESC). Eur J Heart Fail 2021; 23:1610-1632. [PMID: 34498368 PMCID: PMC9292239 DOI: 10.1002/ejhf.2346] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022] Open
Abstract
New biomarkers are being evaluated for their ability to advance the management of patients with heart failure. Despite a large pool of interesting candidate biomarkers, besides natriuretic peptides virtually none have succeeded in being applied into the clinical setting. In this review, we examine the most promising emerging candidates for clinical assessment and management of patients with heart failure. We discuss high-sensitivity cardiac troponins (Tn), procalcitonin, novel kidney markers, soluble suppression of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor-15 (GDF-15), cluster of differentiation 146 (CD146), neprilysin, adrenomedullin (ADM), and also discuss proteomics and genetic-based risk scores. We focused on guidance and assistance with daily clinical care decision-making. For each biomarker, analytical considerations are discussed, as well as performance regarding diagnosis and prognosis. Furthermore, we discuss potential implementation in clinical algorithms and in ongoing clinical trials.
Collapse
Affiliation(s)
- Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain
| | - Alexandre Mebazaa
- Inserm U942-MASCOT; Université de Paris; Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière; FHU PROMICE, Paris, France.,Université de Paris, Paris, France.,Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière, Paris, France.,FHU PROMICE, Paris, France
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - John G F Cleland
- Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow; National Heart & Lung Institute, Imperial College London, London, UK
| | - Andrew J S Coats
- Monash University, Melbourne, Australia.,University of Warwick, Coventry, UK
| | | | | | | | - Thomas Mueller
- Department of Clinical Pathology, Hospital of Bolzano, Bolzano, Italy
| | - A Mark Richards
- Christchurch Heart Institute, Christchurch, New Zealand.,Cardiovascular Research Institute, National University of Singapore, Singapore
| | - Petar Seferovic
- Faculty of Medicine, Belgrade University, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgarde, Serbia
| | | | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
7
|
Potential Biomarkers in Atrial Fibrillation: Insight into their Clinical Significance. J Cardiovasc Pharmacol 2021; 78:184-191. [PMID: 34173807 DOI: 10.1097/fjc.0000000000001042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT In risk-stratifying patients with atrial fibrillation (AF), physicians rely heavily on clinical parameters that provide risk scores and determine treatment strategies. There has been increasing research on potential biomarkers in the blood that could more accurately determine both risk of complications in AF and risk of incidence of AF. This review highlights the clinical significance of five novel biomarkers that have been shown to be linked to AF. These biomarkers are carbohydrate antigen 125 (CA-125), galectin-3 (gal-3), growth differentiating factor-15 (GDF-15), a member of the interleukin 1 receptor family, IL1RL1 (ST2) and N-terminal pro B-type natriuretic peptide (NT-proBNP).
Collapse
|
8
|
Bansal N, Zelnick LR, Soliman EZ, Anderson A, Christenson R, DeFilippi C, Deo R, Feldman HI, He J, Ky B, Kusek J, Lash J, Seliger S, Shafi T, Wolf M, Go AS, Shlipak MG, Appel LJ, Rao PS, Rahman M, Townsend RR. Change in Cardiac Biomarkers and Risk of Incident Heart Failure and Atrial Fibrillation in CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 2021; 77:907-919. [DOI: 10.1053/j.ajkd.2020.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/26/2020] [Indexed: 12/16/2022]
|
9
|
Cleland JGF, Ferreira JP, Mariottoni B, Pellicori P, Cuthbert J, Verdonschot JAJ, Petutschnigg J, Ahmed FZ, Cosmi F, Brunner La Rocca HP, Mamas MA, Clark AL, Edelmann F, Pieske B, Khan J, McDonald K, Rouet P, Staessen JA, Mujaj B, González A, Diez J, Hazebroek M, Heymans S, Latini R, Grojean S, Pizard A, Girerd N, Rossignol P, Collier TJ, Zannad F. The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial. Eur Heart J 2021; 42:684-696. [PMID: 33215209 PMCID: PMC7878013 DOI: 10.1093/eurheartj/ehaa758] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/05/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022] Open
Abstract
Aims To investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. Methods and results Randomized, open-label, blinded-endpoint trial comparing spironolactone (50 mg/day) or control for up to 9 months in people with, or at high risk of, coronary disease and raised plasma B-type natriuretic peptides. The primary endpoint was the interaction between baseline serum galectin-3 and changes in serum procollagen type-III N-terminal pro-peptide (PIIINP) in participants assigned to spironolactone or control. Procollagen type-I C-terminal pro-peptide (PICP) and collagen type-1 C-terminal telopeptide (CITP), reflecting synthesis and degradation of type-I collagen, were also measured. In 527 participants (median age 73 years, 26% women), changes in PIIINP were similar for spironolactone and control [mean difference (mdiff): −0.15; 95% confidence interval (CI) −0.44 to 0.15 μg/L; P = 0.32] but those receiving spironolactone had greater reductions in PICP (mdiff: −8.1; 95% CI −11.9 to −4.3 μg/L; P < 0.0001) and PICP/CITP ratio (mdiff: −2.9; 95% CI −4.3 to −1.5; <0.0001). No interactions with serum galectin were observed. Systolic blood pressure (mdiff: −10; 95% CI −13 to −7 mmHg; P < 0.0001), left atrial volume (mdiff: −1; 95% CI −2 to 0 mL/m2; P = 0.010), and NT-proBNP (mdiff: −57; 95% CI −81 to −33 ng/L; P < 0.0001) were reduced in those assigned spironolactone. Conclusions Galectin-3 did not identify greater reductions in serum concentrations of collagen biomarkers in response to spironolactone. However, spironolactone may influence type-I collagen metabolism. Whether spironolactone can delay or prevent progression to symptomatic heart failure should be investigated. ![]()
Collapse
Affiliation(s)
- John G F Cleland
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow G12 8QQ, UK
| | - João Pedro Ferreira
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | | | - Pierpaolo Pellicori
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow G12 8QQ, UK
| | - Joe Cuthbert
- Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, UK
| | - Job A J Verdonschot
- Department of Cardiology, Maastricht University Medical Center, the Netherlands
| | - Johannes Petutschnigg
- Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, Berlin Institute of Health (BIH), and German Centre for Cardiovascular research (DZHK), Partner Site Berlin, Germany
| | - Fozia Z Ahmed
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Franco Cosmi
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | | | - Mamas A Mamas
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK.,Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK
| | - Andrew L Clark
- Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, UK
| | - Frank Edelmann
- Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, Berlin Institute of Health (BIH), and German Centre for Cardiovascular research (DZHK), Partner Site Berlin, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, Berlin Institute of Health (BIH), and German Centre for Cardiovascular research (DZHK), Partner Site Berlin, Germany.,German Heart Center Berlin, Germany
| | - Javed Khan
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow G12 8QQ, UK
| | - Ken McDonald
- St. Vincent's University Healthcare Group, and School of Medicine, University College Dublin, Dublin, Ireland
| | - Philippe Rouet
- Equipe obésité et insuffisance cardiaque, Université UPS, Inserm I2MC, Toulouse, UMR 1048, France
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Blerim Mujaj
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,Department of Diagnostic and Interventional Radiology, Universitatsklinikum Freiburg, Freiburg, Germany
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA. Universidad de Navarra and IdiSNA, Pamplona, Spain CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Diez
- Program of Cardiovascular Diseases, CIMA. Universidad de Navarra and IdiSNA, Pamplona, Spain CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Departments of Nephrology and Cardiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Mark Hazebroek
- Department of Cardiology, Maastricht University Medical Center, the Netherlands
| | - Stephane Heymans
- Department of Cardiology, Maastricht University Medical Center, the Netherlands
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche "Mario Negri" - IRCCS, Milan, Italy
| | - Stéphanie Grojean
- Fondation Force, Research and Consulting Department, EDDH, Centre de Médecine Préventive, Rue du Doyen Jacques Parisot, Vandoeuvre les Nancy, 54500, France
| | - Anne Pizard
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | - Nicolas Girerd
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | - Patrick Rossignol
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | - Tim J Collier
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Faiez Zannad
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, U1116, France
| | | |
Collapse
|
10
|
Sundqvist M, Andelid K, Ekberg-Jansson A, Bylund J, Karlsson-Bengtsson A, Lindén A. Systemic Galectin-3 in Smokers with Chronic Obstructive Pulmonary Disease and Chronic Bronchitis: The Impact of Exacerbations. Int J Chron Obstruct Pulmon Dis 2021; 16:367-377. [PMID: 33642857 PMCID: PMC7903965 DOI: 10.2147/copd.s283372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The carbohydrate-binding protein Galectin-3 is increased in several inflammatory diseases and has recently been forwarded as a systemic biomarker in chronic obstructive pulmonary disease (COPD). In this longitudinal study, we characterized the level of systemic Galectin-3 using blood from smokers with a history of COPD and chronic bronchitis (COPD-CB), during stable clinical conditions and exacerbations. PATIENTS AND METHODS The study population comprised 56 long-term smokers with COPD-CB, 10 long-term smokers without lung disease (LTS) and 10 clinically healthy never-smokers (HNS). Blood samples were analyzed for levels of Galectin-3, leukocyte populations and C-reactive protein (CRP). In addition, sputum samples from the COPD-CB group were analyzed for bacterial growth. RESULTS When comparing stable clinical conditions and exacerbations in the COPD-CB group, we found that the level of Galectin-3, just like that of CRP, leukocytes and neutrophils, respectively, was increased during exacerbations. However, this exacerbation-associated increase of Galectin-3 was modest. During stable clinical conditions of COPD-CB, the level of Galectin-3 was not elevated in comparison with HNS or LTS. Nor did this level of Galectin-3 distinguish patients that remained in a clinically stable condition throughout the study to those that developed an exacerbation. In addition, neither during stable clinical conditions nor during exacerbations, did the presence of bacterial growth in sputum alter Galectin-3 levels. In contrast to Galectin-3, the level of CRP, leukocytes and neutrophils, respectively, were increased during clinical stable conditions in the COPD-CB group compared with the other groups and were further enhanced during exacerbations. CONCLUSION Systemic Galectin-3 is increased in a reproducible but modest manner during exacerbations in smokers with COPD-CB. During stable clinical conditions, the level of systemic Galectin-3 does not distinguish patients that remain clinically stable from those that develop exacerbations. This makes it less likely that systemic Galectin-3 may become a clinically useful biomarker in the current setting.
Collapse
Grants
- Magnus Bergwall foundation (MS), the Rådman and Mrs Ernst Colliander foundation (MS), the Rune and Ulla Almlövs Foundation (MS), IFs foundation and Elisabeth and Alfred Ahlqvist’s foundation – Swedish pharmacy Society (MS), the Swedish Medical Research Council (JB, AK and AL), federal funding under the ALF agreement for Region Västra Götaland (AK and AL), federal funding under the LUA agreement for Region Stockholm (AL), the Arne and Inga-Britt Lundberg foundation (AK), the Swedish Heart-Lung Foundation (JB, AK and AL), the King Gustaf V 80-years foundation (AK), the King Gustaf V’s and Queen Victoria’s Freemason Research Foundation (AL) and by federal funding from Karolinska Institutet (AL)
Collapse
Affiliation(s)
- Martina Sundqvist
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Andelid
- COPD Center, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Ekberg-Jansson
- Department of Respiratory Medicine and Allergology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Bylund
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Karlsson-Bengtsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Anders Lindén
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Karolinska Severe COPD Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
11
|
Trippel TD, Mende M, Düngen HD, Hashemi D, Petutschnigg J, Nolte K, Herrmann-Lingen C, Binder L, Hasenfuss G, Pieske B, Wachter R, Edelmann F. The diagnostic and prognostic value of galectin-3 in patients at risk for heart failure with preserved ejection fraction: results from the DIAST-CHF study. ESC Heart Fail 2021; 8:829-841. [PMID: 33566456 PMCID: PMC8006663 DOI: 10.1002/ehf2.13174] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 01/30/2023] Open
Abstract
Aims Galectin‐3 (Gal‐3) predicts long‐term outcome among patients with heart failure (HF) with preserved ejection fraction (HFpEF). The ability of Gal‐3 to diagnose and predict incident HFpEF in a cohort at risk for HFpEF is of particular interest. We aimed to determine the association between Gal‐3 and clinical manifestations of HFpEF, the relationship between Gal‐3 and all‐cause mortality, or the composite of cardiovascular hospitalization and death. Methods and results The observational Diast‐CHF study included patients aged 50 to 85 years with ≥1 risk factor for HF (e.g. hypertension, diabetes mellitus, and atherosclerotic disease) or previously suspected HF. Patients were followed for 10 years. The association between Gal‐3, evidence of diastolic dysfunction, and Framingham criteria for HF was examined. All deaths and hospitalizations were adjudicated as cardiovascular or non‐cardiovascular. The analysis population was composed of 1386 subjects (67 years old, 50.9% female). The area under the receiver operating characteristic curve to diagnose HFpEF was 0.71. At a cut‐off value of 13.57 ng/mL, sensitivity was 0.61 and specificity was 0.73 for Gal‐3, and the diagnostic power to detect HFpEF was superior to N‐terminal pro‐brain natriuretic peptide (area under the receiver operating characteristic curve 0.59, P > 0.001). Baseline Gal‐3 was associated with risk factors for HF (P < 0.001). Higher levels of Gal‐3 predicted incident HFpEF (P < 0.05), adjusted all‐cause mortality (P < 0.001), and the adjusted composite of cardiovascular hospitalization and death (P < 0.001), both independent from N‐terminal pro‐brain natriuretic peptide. Conclusions Gal‐3 differentiated patients with HFpEF from an overall cohort of well‐characterized patients with risk factors for HFpEF. Independent of other factors, baseline Gal‐3 levels were associated with a higher risk for incident HFpEF, mortality, or the composite of cardiovascular hospitalization and death over 10 year follow‐up. In conjunction with clinical parameters, Gal‐3 adds a statistically significant value for the diagnosis of HFpEF within this study, yet the clinical relevance remains debatable.
Collapse
Affiliation(s)
- Tobias Daniel Trippel
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Meinhard Mende
- Clinical Trial Centre (KKS) and Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Djawid Hashemi
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Johannes Petutschnigg
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Kathleen Nolte
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Lutz Binder
- DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Department of Clinical Chemistry, University of Göttingen Medical Centre, Göttingen, Germany
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Department of Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Rolf Wachter
- Department of Cardiology and Pneumology, Heart Center Göttingen, Göttingen, Germany.,DZHK (German Cardiovascular Research Center), partner site Göttingen, Göttingen, Germany.,Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Frank Edelmann
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
12
|
Tazhitdinova R, Timoshenko AV. The Emerging Role of Galectins and O-GlcNAc Homeostasis in Processes of Cellular Differentiation. Cells 2020; 9:cells9081792. [PMID: 32731422 PMCID: PMC7465113 DOI: 10.3390/cells9081792] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 02/07/2023] Open
Abstract
Galectins are a family of soluble β-galactoside-binding proteins with diverse glycan-dependent and glycan-independent functions outside and inside the cell. Human cells express twelve out of sixteen recognized mammalian galectin genes and their expression profiles are very different between cell types and tissues. In this review, we summarize the current knowledge on the changes in the expression of individual galectins at mRNA and protein levels in different types of differentiating cells and the effects of recombinant galectins on cellular differentiation. A new model of galectin regulation is proposed considering the change in O-GlcNAc homeostasis between progenitor/stem cells and mature differentiated cells. The recognition of galectins as regulatory factors controlling cell differentiation and self-renewal is essential for developmental and cancer biology to develop innovative strategies for prevention and targeted treatment of proliferative diseases, tissue regeneration, and stem-cell therapy.
Collapse
|
13
|
Aguilar D, Sun C, Hoogeveen RC, Nambi V, Selvin E, Matsushita K, Saeed A, McEvoy JW, Shah AM, Solomon SD, Boerwinkle E, Ballantyne CM. Levels and Change in Galectin-3 and Association With Cardiovascular Events: The ARIC Study. J Am Heart Assoc 2020; 9:e015405. [PMID: 32573308 PMCID: PMC7670497 DOI: 10.1161/jaha.119.015405] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background Circulating galectin‐3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin‐3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin‐3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin‐3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996–1998; n=9247) and at ARIC visit 5 (2011–2013; n=4829). Higher galectin‐3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06–1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01–2.00), HF (HR, 1.44; 95% CI, 1.17–1.76), and mortality (HR, 1.56; 95% CI, 1.35–1.80). At visit 5 (median age, 74), higher galectin‐3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15–3.24) and total mortality (HR, 1.70; 95% CI, 1.15–2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin‐3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community‐based cohort, galectin‐3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin‐3 levels over this period was also associated with increased risk.
Collapse
Affiliation(s)
- David Aguilar
- Department of Epidemiology, Human Genetics, and Environmental Sciences School of Public Health University of Texas Health Science Center at Houston TX
| | | | - Ron C Hoogeveen
- Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX
| | - Vijay Nambi
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX.,Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX.,Department of Medicine Michael E. DeBakey Veterans Affairs Medical Center Houston TX
| | - Elizabeth Selvin
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Kunihiro Matsushita
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Anum Saeed
- Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA
| | - John W McEvoy
- Department of Medicine Ciccarone Center for the Prevention of Heart Disease Johns Hopkins School of Medicine Baltimore MD.,National University of Ireland and National Institute for Prevention and Cardiovascular Health Galway Ireland
| | - Amil M Shah
- Division of Cardiovascular Medicine Department of Medicine Brigham and Women's Hospital Boston MA
| | - Scott D Solomon
- Division of Cardiovascular Medicine Department of Medicine Brigham and Women's Hospital Boston MA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences School of Public Health University of Texas Health Science Center at Houston TX
| | - Christie M Ballantyne
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX.,Section of Cardiovascular Research Department of Medicine Baylor College of Medicine Houston TX.,Center for Cardiometabolic Disease Prevention Department of Medicine Baylor College of Medicine Houston TX
| |
Collapse
|
14
|
Suthahar N, Meems LMG, Ho JE, de Boer RA. Sex-related differences in contemporary biomarkers for heart failure: a review. Eur J Heart Fail 2020; 22:775-788. [PMID: 32220046 PMCID: PMC7319414 DOI: 10.1002/ejhf.1771] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 12/28/2022] Open
Abstract
The use of circulating biomarkers for heart failure (HF) is engrained in contemporary cardiovascular practice and provides objective information about various pathophysiological pathways associated with HF syndrome. However, biomarker profiles differ considerably among women and men. For instance, in the general population, markers of cardiac stretch (natriuretic peptides) and fibrosis (galectin‐3) are higher in women, whereas markers of cardiac injury (cardiac troponins) and inflammation (sST2) are higher in men. Such differences may reflect sex‐specific pathogenic processes associated with HF risk, but may also arise as a result of differences in sex hormone profiles and fat distribution. From a clinical perspective, sex‐related differences in biomarker levels may affect the objectivity of biomarkers in HF management because what is considered to be ‘normal’ in one sex may not be so in the other. The objectives of this review are, therefore: (i) to examine the sex‐specific dynamics of clinically relevant HF biomarkers in the general population, as well as in HF patients; (ii) to discuss the overlap between sex‐related and obesity‐related effects, and (iii) to identify knowledge gaps to stimulate research on sex‐related differences in
HF.
Collapse
Affiliation(s)
- Navin Suthahar
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Laura M G Meems
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Jennifer E Ho
- Division of Cardiology, Department of Medicine, and Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rudolf A de Boer
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| |
Collapse
|
15
|
Coats AJS. Figures of the Heart Failure Association (HFA): Dr. Rudolf de Boer, HFA Board Member (2014-2020), Chair of the Basic Science Section (2016-2018), coordinator of the Study Group on Heart Failure with Preserved Ejection Fraction, and member of the HFA study groups of Translational Research and Cardio-oncology. Eur J Heart Fail 2020; 22:572-575. [PMID: 32128968 DOI: 10.1002/ejhf.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/09/2022] Open
|
16
|
Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases. Biomolecules 2020; 10:biom10030389. [PMID: 32138174 PMCID: PMC7175224 DOI: 10.3390/biom10030389] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 12/11/2022] Open
Abstract
Galectin-3 is a β-galactoside-binding lectin which is important in numerous biological activities in various organs, including cell proliferation, apoptotic regulation, inflammation, fibrosis, and host defense. Galectin-3 is predominantly located in the cytoplasm and expressed on the cell surface, and then often secreted into biological fluids, like serum and urine. It is also released from injured cells and inflammatory cells under various pathological conditions. Many studies have revealed that galectin-3 plays an important role as a diagnostic or prognostic biomarker for certain types of heart disease, kidney disease, viral infection, autoimmune disease, neurodegenerative disorders, and tumor formation. In particular, it has been recognized that galectin-3 is extremely useful for detecting many of these diseases in their early stages. The purpose of this article is to review and summarize the recent literature focusing on the biomarker characteristics and long-term outcome predictions of galectin-3, in not only patients with various types of diseases, but associated animal models.
Collapse
|
17
|
Kurlianskaya EK, Mrochek AG, Denisevich TL, Kaliadka MG, Russkich II. [The Prognostic Role of Biomarkers in Patients With Chronic Heart Failure]. ACTA ACUST UNITED AC 2020; 60:16-22. [PMID: 32245350 DOI: 10.18087/cardio.2020.1.n882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
Objective Investigate the role of biomarkers in the prognosis of the clinical course of the disease in patients with chronic heart failure (CHF) of different NYHA functional classes (FC).Material and Methods The study included 132 patients with CHF: Group 1 was composed of 70 patients with NYHA FC II CHF, and Group 2 included 62 patients with FC III-IV CHF. The patients underwent clinical, instrumental, functional, and laboratory measurements, which included serum concentrations of NT-proBNP, ST-2, galectin-3, and C-reactive protein. Patients were examined at baseline and at 3, 6, and 12 mos of follow-up. The following cardiac complications were used as endpoints: urgent hospitalization due to decompensated CHF, heart transplantation, cardiovascular death. Endpoints were registered during the 12-mo follow-up period.Results Endpoints were recorded for 58 patients (44%) of the total sample of patients with CHF: 38 patients were urgently hospitalized, 10 patients underwent heart transplantation, 10 patients died. Cardiac complications were recorded at a higher rate in patients with FC III-IV CHF (63% vs. 27% of patients with FC II; p<0.001). In FC II CHF patients, the incidence of cardiac complications was significantly correlated with NT-proBNP blood concentrations (Rpb=0.53; p=0.023), left ventricular end-diastolic volume (LVEDV) (Rpb=0.50; p=0.044), and mitral regurgitation (Rpb=0.53; p=0.038). Cardiac complications in patients with FC III-IV CHF were associated with ST-2 (Rpb=0.52; p=0.004) and galectin-3 (Rpb=0.46; p=0.009) blood concentrations, and with systolic pulmonary artery pressure (PAP) (Rpb=0.41; p=0.014). Unlike other laboratory measurements, galectin-3 concentrations were significantly correlated with type 2 diabetes mellitus (DM2) (Rpb=0.40; p=0.003). In this study, correlation analysis and evidence of significant differences in the concentrations of biomarkers provided a rationale for identifying potential predictors of severe cardiac complications during medium- and long-term follow-up periods in patients with CHF of different severity: NT-proBNP concentrations in FC II patients; ST-2 and galectin-3 serum concentrations in FC III-IV patients; galectin-3 concentrations in patients with CHF and DM2.Conclusion NT-proBNP blood concentrations are associated with CHF severity and serious cardiac complications in patients with FC II CHF within the following 12 mos. The poor prognosis of FC III-IV CHF is associated with the concentration of the ST-2 biomarker. The blood concentration of galectin-3 is a significant predictor of poor prognosis in patients with CHF and DM2. Predictors of the adverse course of CHF of varying severity were differentiated. For FC II CHF, NT-proBNP > 1723 pg/ml or, if NT-proBNP < 1723 pg/mL, then EDV > 311 ml. For FC III-IV CHF, ST-2 > 67 ng/mL or, if ST-2 < 67 ng/mL, then PAP > 61 mm Hg. Galectin-3 has a prognostic value for the clinical course of the disease at different follow-up periods in patients with CHF and DM2: galectin-3 concentrations > 16 ng/mL and 13-16 ng/mL are risk factors for mid- and long-term cardiac complications, respectively.
Collapse
Affiliation(s)
| | - A G Mrochek
- Republican Scientific and Practical Center "Cardiology"
| | | | - M G Kaliadka
- Republican Scientific and Practical Center "Cardiology"
| | - I I Russkich
- Republican Scientific and Practical Center "Cardiology"
| |
Collapse
|
18
|
Gong M, Cheung A, Wang QS, Li G, Goudis CA, Bazoukis G, Lip GYH, Baranchuk A, Korantzopoulos P, Letsas KP, Tse G, Liu T. Galectin-3 and risk of atrial fibrillation: A systematic review and meta-analysis. J Clin Lab Anal 2020; 34:e23104. [PMID: 31917884 PMCID: PMC7083505 DOI: 10.1002/jcla.23104] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/25/2018] [Accepted: 12/21/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Galectin-3 is an inflammatory marker that is raised in myocardial fibrosis and inflammation. Recent studies have explored its role in predicting atrial fibrillation (AF) outcomes. The aim of this systematic review and meta-analysis is to examine the association between serum concentration of galectin-3 and AF. METHODS PubMed, EMBASE, and the Cochrane Database were searched. A total of 280 studies were identified, of which 28 studies involving 10 830 patients were included in our meta-analysis. RESULTS Galectin-3 is present at higher concentrations in patients with AF than those in sinus rhythm (mean difference [MD] = -0.68 ng/mL, 95% CI: -0.92, -0.44, Z = 5.61, P < .00001). Galectin-3 levels were significantly higher in the persistent AF than in the paroxysmal AF group (MD = -0.94 ng/mL, 95% CI: -1.85, -0.03, Z = 2.04, P = .04). Higher galectin-3 levels were associated with a 45% increase in the odds of developing AF (odds ratio [OR] = 1.45, 95% CI: 1.15, 1.83, Z = 3.11, P = .002) and risk of AF recurrence (hazard ratio [HR] =1.17, 95% CI: 1.06, 1.29, Z = 3.12, P = .002). CONCLUSIONS Our meta-analysis found that galectin-3 is significantly higher in patients with persistent AF than in those with paroxysmal AF, and can predict both AF development and recurrence after treatment.
Collapse
Affiliation(s)
- Mengqi Gong
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Angel Cheung
- Department of Biomedical Engineering, Brown University, Brown, Michigan
| | - Qun-Shan Wang
- Department of Cardiology, Xinhua Hospital affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | | | - George Bazoukis
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Gregory Y H Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Adrian Baranchuk
- Department of Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | | | - Konstantinos P Letsas
- Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| |
Collapse
|
19
|
Association of Galectin-3 and Soluble ST2, and Their Changes, with Echocardiographic Parameters and Development of Heart Failure after ST-Segment Elevation Myocardial Infarction. DISEASE MARKERS 2019; 2019:9529053. [PMID: 31687050 PMCID: PMC6811795 DOI: 10.1155/2019/9529053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/23/2019] [Indexed: 12/25/2022]
Abstract
Purpose To investigate the association of galectin-3 (Gal-3) and soluble ST2 (sST2) and their follow-up changes with the development of heart failure (HF) and echocardiographic parameters of HF (ejection fraction, atrial and ventricular size, left ventricular hypertrophy, e′, and E/e′) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods A prospective, observational study, BIOSTRAT (Biomarkers for Risk Stratification After STEMI), enrolled 117 patients between October 2014 and April 2017. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). The primary endpoint was HF onset at one-year follow-up. Secondary assessments included associations of biomarker concentration with echocardiographic indices of systolic and diastolic dysfunction at baseline and at one year. Results Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were significantly increased at one-year follow-up (8.5 ng/mL and p < 0.001 and 31.4 ng/mL and p = 0.001, respectively). Patients who reached the primary endpoint (50 patients (48%)) had significantly higher baseline concentrations of both biomarkers and a higher Gal-3 level at one year compared to patients who did not. Both Gal-3 and sST2 were predictors of the primary endpoint in univariate logistic regression analysis, but only Gal-3 remained significant in multivariate analysis. There was no clear association between both biomarkers and echocardiographic parameters. Conclusions Baseline, but not one-year, changes of Gal-3 and sST2 concentrations may be useful for risk stratification after STEMI. However, only Gal-3 was the independent predictor of HF development at one-year observation. This trial is registered with NCT03735719.
Collapse
|
20
|
de Boer RA, Nayor M, deFilippi CR, Enserro D, Bhambhani V, Kizer JR, Blaha MJ, Brouwers FP, Cushman M, Lima JAC, Bahrami H, van der Harst P, Wang TJ, Gansevoort RT, Fox CS, Gaggin HK, Kop WJ, Liu K, Vasan RS, Psaty BM, Lee DS, Hillege HL, Bartz TM, Benjamin EJ, Chan C, Allison M, Gardin JM, Januzzi JL, Shah SJ, Levy D, Herrington DM, Larson MG, van Gilst WH, Gottdiener JS, Bertoni AG, Ho JE. Association of Cardiovascular Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction. JAMA Cardiol 2019; 3:215-224. [PMID: 29322198 DOI: 10.1001/jamacardio.2017.4987] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Importance Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF) as opposed to reduced ejection fraction (HFrEF), yet associations of biomarkers with future heart failure subtype are incompletely understood. Objective To evaluate the associations of 12 cardiovascular biomarkers with incident HFpEF vs HFrEF among adults from the general population. Design, Setting, and Participants This study included 4 longitudinal community-based cohorts: the Cardiovascular Health Study (1989-1990; 1992-1993 for supplemental African-American cohort), the Framingham Heart Study (1995-1998), the Multi-Ethnic Study of Atherosclerosis (2000-2002), and the Prevention of Renal and Vascular End-stage Disease study (1997-1998). Each cohort had prospective ascertainment of incident HFpEF and HFrEF. Data analysis was performed from June 25, 2015, to November 9, 2017. Exposures The following biomarkers were examined: N-terminal pro B-type natriuretic peptide or brain natriuretic peptide, high-sensitivity troponin T or I, C-reactive protein (CRP), urinary albumin to creatinine ratio (UACR), renin to aldosterone ratio, D-dimer, fibrinogen, soluble suppressor of tumorigenicity, galectin-3, cystatin C, plasminogen activator inhibitor 1, and interleukin 6. Main Outcomes and Measures Development of incident HFpEF and incident HFrEF. Results Among the 22 756 participants in these 4 cohorts (12 087 women and 10 669 men; mean [SD] age, 60 [13] years) in the study, during a median follow-up of 12 years, 633 participants developed incident HFpEF, and 841 developed HFrEF. In models adjusted for clinical risk factors of heart failure, 2 biomarkers were significantly associated with incident HFpEF: UACR (hazard ratio [HR], 1.33; 95% CI, 1.20-1.48; P < .001) and natriuretic peptides (HR, 1.27; 95% CI, 1.16-1.40; P < .001), with suggestive associations for high-sensitivity troponin (HR, 1.11; 95% CI, 1.03-1.19; P = .008), plasminogen activator inhibitor 1 (HR, 1.22; 95% CI, 1.03-1.45; P = .02), and fibrinogen (HR, 1.12; 95% CI, 1.03-1.22; P = .01). By contrast, 6 biomarkers were associated with incident HFrEF: natriuretic peptides (HR, 1.54; 95% CI, 1.41-1.68; P < .001), UACR (HR, 1.21; 95% CI, 1.11-1.32; P < .001), high-sensitivity troponin (HR, 1.37; 95% CI, 1.29-1.46; P < .001), cystatin C (HR, 1.19; 95% CI, 1.11-1.27; P < .001), D-dimer (HR, 1.22; 95% CI, 1.11-1.35; P < .001), and CRP (HR, 1.19; 95% CI, 1.11-1.28; P < .001). When directly compared, natriuretic peptides, high-sensitivity troponin, and CRP were more strongly associated with HFrEF compared with HFpEF. Conclusions and Relevance Biomarkers of renal dysfunction, endothelial dysfunction, and inflammation were associated with incident HFrEF. By contrast, only natriuretic peptides and UACR were associated with HFpEF. These findings highlight the need for future studies focused on identifying novel biomarkers of the risk of HFpEF.
Collapse
Affiliation(s)
- Rudolf A de Boer
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Matthew Nayor
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston
| | | | - Danielle Enserro
- Department of Preventive Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Vijeta Bhambhani
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston.,Cardiovascular Research Center, Massachusetts General Hospital, Boston
| | - Jorge R Kizer
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, The Johns Hopkins University, Baltimore, Maryland
| | - Frank P Brouwers
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Mary Cushman
- Division of Hematology/Oncology, Department of Medicine, University of Vermont Larner College of Medicine, Burlington
| | - Joao A C Lima
- Department of Medicine, Johns Hopkins Medical Institutions, The Johns Hopkins University, Baltimore, Maryland.,Department of Cardiology, Heart and Vascular Institute, Johns Hopkins Medical Institutions, The Johns Hopkins University, Baltimore, Maryland
| | - Hossein Bahrami
- Division of Cardiovascular Medicine, Keck School of Medicine of University of Southern California, Los Angeles
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Thomas J Wang
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ron T Gansevoort
- Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Caroline S Fox
- Center for Population Studies, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Hanna K Gaggin
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston
| | - Willem J Kop
- Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ramachandran S Vasan
- Framingham Heart Study, Framingham, Massachusetts.,Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.,Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle.,Kaiser Permanente Washington Health Research Institute, Seattle
| | - Douglas S Lee
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Hans L Hillege
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Traci M Bartz
- Department of Biostatistics, University of Washington, Seattle
| | - Emelia J Benjamin
- Framingham Heart Study, Framingham, Massachusetts.,Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.,Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts
| | - Cheeling Chan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla
| | - Julius M Gardin
- Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Newark
| | - James L Januzzi
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston
| | - Sanjiv J Shah
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Levy
- Center for Population Studies, National Heart, Lung, and Blood Institute, Bethesda, Maryland.,Framingham Heart Study, Framingham, Massachusetts
| | - David M Herrington
- Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Martin G Larson
- Department of Preventive Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Wiek H van Gilst
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | | | - Alain G Bertoni
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jennifer E Ho
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston.,Cardiovascular Research Center, Massachusetts General Hospital, Boston
| |
Collapse
|
21
|
Du X, Zhao W, Nguyen M, Lu Q, Kiriazis H. β-Adrenoceptor activation affects galectin-3 as a biomarker and therapeutic target in heart disease. Br J Pharmacol 2019; 176:2449-2464. [PMID: 30756388 PMCID: PMC6592856 DOI: 10.1111/bph.14620] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/11/2018] [Accepted: 01/29/2019] [Indexed: 12/12/2022] Open
Abstract
Myocardial fibrosis is a key histopathological component that drives the progression of heart disease leading to heart failure and constitutes a therapeutic target. Recent preclinical and clinical studies have implicated galectin-3 (Gal-3) as a pro-fibrotic molecule and a biomarker of heart disease and fibrosis. However, our knowledge is poor on the mechanism(s) that determine the blood level or regulate cardiac expression of Gal-3. Recent studies have demonstrated that enhanced β-adrenoceptor activity is a determinant of both circulating concentration and cardiac expression of Gal-3. Pharmacological or transgenic activation of β-adrenoceptors leads to increased blood levels of Gal-3 and up-regulated cardiac Gal-3 expression, effect that can be reversed with the use of β-adrenoceptor antagonists. Conversely, Gal-3 gene deletion confers protection against isoprenaline-induced cardiotoxicity and fibrogenesis. At the transcription level, β-adrenoceptor stimulation activates cardiac mammalian sterile-20-like kinase 1, a pivotal kinase of the Hippo signalling pathway, which is associated with Gal-3 up-regulation. Recent studies have suggested a role for the β-adrenoceptor-Hippo signalling pathway in the regulation of cardiac Gal-3 expression thereby contributing to the onset and progression of heart disease. This implies a therapeutic potential of the suppression of Gal-3 expression. In this review, we discuss the effects of β-adrenoceptor activity on Gal-3 as a biomarker and causative mediator in the setting of heart disease and point out pivotal knowledge gaps. LINKED ARTICLES: This article is part of a themed section on Adrenoceptors-New Roles for Old Players. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.14/issuetoc.
Collapse
Affiliation(s)
- Xiao‐Jun Du
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
- Department of Physiology and Pathophysiology, School of Medical SciencesXi'an Jiaotong University Health Science CenterXi'anChina
| | - Wei‐Bo Zhao
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
| | - My‐Nhan Nguyen
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
| | - Qun Lu
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
- Department of Cardiovascular Medicine, First HospitalXi'an Jiaotong University Health Science CenterXi'anChina
| | - Helen Kiriazis
- Experimental Cardiology LaboratoryBaker Heart and Diabetes InstituteMelbourneVICAustralia
| |
Collapse
|
22
|
Crnkovic S, Egemnazarov B, Damico R, Marsh LM, Nagy BM, Douschan P, Atsina K, Kolb TM, Mathai SC, Hooper JE, Ghanim B, Klepetko W, Fruhwald F, Lassner D, Olschewski A, Olschewski H, Hassoun PM, Kwapiszewska G. Disconnect between Fibrotic Response and Right Ventricular Dysfunction. Am J Respir Crit Care Med 2019; 199:1550-1560. [PMID: 30557518 PMCID: PMC6580669 DOI: 10.1164/rccm.201809-1737oc] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/14/2018] [Indexed: 12/29/2022] Open
Abstract
Rationale: Remodeling and fibrosis of the right ventricle (RV) may cause RV dysfunction and poor survival in patients with pulmonary hypertension. Objectives: To investigate the consequences of RV fibrosis modulation and the accompanying cellular changes on RV function. Methods: Expression of fibrotic markers was assessed in the RV of patients with pulmonary hypertension, the murine pulmonary artery banding, and rat monocrotaline and Sugen5416/hypoxia models. Invasive hemodynamic and echocardiographic assessment was performed on galectin-3 knockout or inhibitor-treated mice. Measurements and Main Results: Established fibrosis was characterized by marked expression of galectin-3 and an enhanced number of proliferating RV fibroblasts. Galectin-3 genetic and pharmacologic inhibition or antifibrotic treatment with pirfenidone significantly diminished RV fibrosis progression in the pulmonary artery banding model, without improving RV functional parameters. RV fibrotic regions were populated with mesenchymal cells coexpressing vimentin and PDGFRα (platelet-derived growth factor receptor-α), but generally lacked αSMA (α-smooth muscle actin) positivity. Serum levels of galectin-3 were increased in patients with idiopathic pulmonary arterial hypertension but did not correlate with cardiac function. No changes of galectin-3 expression were observed in the lungs. Conclusions: We identified extrapulmonary galectin-3 as an important mediator that drives RV fibrosis in pulmonary hypertension through the expansion of PDGFRα/vimentin-expressing cardiac fibroblasts. However, interventions effectively targeting fibrosis lack significant beneficial effects on RV function.
Collapse
Affiliation(s)
- Slaven Crnkovic
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | | | - Rachel Damico
- Division of Pulmonary and Critical Care Medicine and
| | - Leigh M. Marsh
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Bence M. Nagy
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Philipp Douschan
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Division of Pulmonology
| | - Kwame Atsina
- Division of Cardiology, University of California, Davis, Davis, California
| | - Todd M. Kolb
- Division of Pulmonary and Critical Care Medicine and
| | | | - Jody E. Hooper
- Department of Pathology, Johns Hopkins, Baltimore, Maryland
| | - Bahil Ghanim
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria; and
| | - Walter Klepetko
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria; and
| | | | - Dirk Lassner
- Institute for Cardiac Diagnostic and Therapy, Berlin, Germany
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | | | | | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Center, Physiology, Medical University of Graz, Graz, Austria
| |
Collapse
|
23
|
Ghorbani A, Bhambhani V, Christenson RH, Meijers WC, de Boer RA, Levy D, Larson MG, Ho JE. Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes. J Am Coll Cardiol 2018; 72:3246-3254. [PMID: 30573026 PMCID: PMC6516745 DOI: 10.1016/j.jacc.2018.09.076] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/12/2018] [Accepted: 09/22/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Galectin-3 (Gal-3) has been associated with heart failure (HF) and poor cardiovascular outcomes. However, the effect of longitudinal changes in Gal-3 on clinical outcomes remains unclear. OBJECTIVES The authors sought to study clinical determinants of change in Gal-3 among community-dwelling individuals. Further, they sought to examine the role of serial Gal-3 measurements in predicting risk of future HF, cardiovascular disease (CVD), and mortality. METHODS A total of 2,477 participants in the Framingham Heart Study Offspring cohort underwent measurement of plasma Gal-3 levels at 2 examinations (1995 to 1998 and 2005 to 2008). Linear regression models were used to examine clinical correlates of change in Gal-3. Proportional hazards models were used to relate future clinical outcomes with change in Gal-3. RESULTS The following clinical correlates were associated with greater longitudinal increases in Gal-3 levels: age, female sex, hypertension, diabetes, body mass index, interim development of chronic kidney disease, and HF (p < 0.0001 for all in multivariable model). Change in Gal-3 was associated with future HF (hazard ratio [HR]: 1.39 per 1-SD increase; 95% confidence interval [CI]: 1.13 to 1.71), CVD (HR: 1.29; 95% CI: 1.11 to 1.51), and all-cause mortality (HR: 1.30; 95% CI: 1.17 to 1.46). Change in Gal-3 was associated with both HF with preserved as well as reduced ejection fraction (p < 0.05 for both). CONCLUSIONS Longitudinal changes in Gal-3 are associated with traditional cardiovascular risk factors and renal disease. In turn, change in Gal-3 predicts future HF, CVD, and mortality in the community. Future studies are needed to determine whether serial Gal-3 measures may be useful in disease prevention.
Collapse
Affiliation(s)
- Anahita Ghorbani
- Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, Connecticut
| | - Vijeta Bhambhani
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Daniel Levy
- National Heart, Lung, and Blood Institute, Boston University's Framingham Heart Study, Framingham, Massachusetts; Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Martin G Larson
- Framingham Heart Study, Framingham, Massachusetts; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Jennifer E Ho
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
| |
Collapse
|
24
|
Clementy N, Garcia B, André C, Bisson A, Benhenda N, Pierre B, Bernard A, Fauchier L, Piver E, Babuty D. Galectin-3 level predicts response to ablation and outcomes in patients with persistent atrial fibrillation and systolic heart failure. PLoS One 2018; 13:e0201517. [PMID: 30067817 PMCID: PMC6070283 DOI: 10.1371/journal.pone.0201517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/17/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Mechanisms of maintenance of both atrial fibrillation and structural left ventricular disease are known to include fibrosis. Galectin-3, a biomarker of fibrosis, is elevated both in patients with heart failure and persistent atrial fibrillation. We sought to find whether galectin-3 has a prognostic value in patients with heart failure and a reduced left ventricular ejection fraction undergoing ablation of persistent atrial fibrillation. Methods Serum concentrations of galectin-3 were determined in a consecutive series of patients with an ejection fraction ≤40%, addressed for ablation of persistent atrial fibrillation. Responders to ablation were patients in sinus rhythm and with an ejection fraction ≥50% at 6 months. A combined endpoint of heart failure hospitalization, transplantation and/or death was used at 12 months. Results Seventy-five patients were included (81% male, age 63±10 years, ejection fraction 34±7%, galectin-3 21±12 ng/mL). During follow-up, eight patients were hospitalized for decompensated heart failure, 1 underwent heart transplantation, and 4 died; 50 patients were considered as responders to ablation. After adjustment, galectin-3 level independently predicted both 6-month absence of response to ablation (OR = 0.89 per unit increase, p = 0.002). Patients with galectin-3 levels <26 had a 95% 1-year event-free survival versus 46% in patients with galectin-3 ≥26 ng/mL (p<0.0001). Conclusions Galectin-3 levels independently predict outcomes in patients with reduced left ventricular systolic function addressed for ablation of persistent AF, and may be of interest in defining the therapeutic strategy in this population.
Collapse
Affiliation(s)
- Nicolas Clementy
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
- * E-mail:
| | - Bruno Garcia
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Clémentine André
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Arnaud Bisson
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Nazih Benhenda
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Bertrand Pierre
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Anne Bernard
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Laurent Fauchier
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| | - Eric Piver
- Biochemistry Department, Trousseau Hospital, University of Tours, Tours, France
| | - Dominique Babuty
- Cardiology Department, Trousseau Hospital, University of Tours, Tours, France
| |
Collapse
|
25
|
Abstract
Galectin-3 plays a role in tissue inflammation, repair, and fibrosis. This article specifically focuses on heart failure (HF), in which galectin-3 has been shown to be a useful biomarker in prognosis and risk stratification, especially in HF with preserved ejection fraction. Experimental research has shown that galectin-3 directly induces pathologic remodeling of the heart, and is therefore considered a culprit protein in the development of cardiac fibrosis in HF, with potentially relevant clinical implications. In summary, galectin-3 is a biomarker and biotarget in cardiac remodeling and fibrosis and future research will target galectin-3-centered diseases.
Collapse
|
26
|
Navarro-Alvarez N, Goncalves B, Andrews AR, Wang Z, Wang Z, Harrington E, Shah J, Sachs DH, Eliaz I, Huang CA. The effects of galectin-3 depletion apheresis on induced skin inflammation in a porcine model. J Clin Apher 2018; 33:486-493. [PMID: 29572917 DOI: 10.1002/jca.21624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 12/20/2022]
Abstract
Galectin-3 (Gal-3), a β-galactoside-binding lectin that is expressed in mammalian cells, is known to modulate several biological functions such as cell-cell adhesion, macrophage activation, angiogenesis, metastasis, and fibrosis. The goal of this study was to evaluate the ability of Gal-3 depletion apheresis using an adsorption column with immobilized anti-Gal-3-antibody to reduce inflammation induced by Complete Freund's Adjuvant injection in a skin inflammation porcine model. Here, we report that plasma perfusion by apheresis through a Gal-3 binding immuno-affinity column reduces plasma Gal-3 levels to below limits of quantitative detection, and results in significant decrease in skin inflammation, including degree and duration of inflammatory lesions. Human plasma was tested ex vivo and found to be efficiently depleted using the anti-Gal-3 affinity column. This study demonstrates the potential of Gal-3 depletion apheresis as a therapeutic method for inflammation-mediated disease, supporting continued research in this area for clinical application.
Collapse
Affiliation(s)
- Nalu Navarro-Alvarez
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Beatriz Goncalves
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alec R Andrews
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zhaohui Wang
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zhirui Wang
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edward Harrington
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jigesh Shah
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David H Sachs
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Isaac Eliaz
- Amitabha Medical Clinic and Healing Center, Santa Rosa, California
| | - Christene A Huang
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
27
|
Abstract
BACKGROUND The incidence of cardiovascular events is higher in patients with primary aldosteronism than in patients with essential hypertension (EHT), despite similar blood pressure levels. This suggests detrimental cardiovascular effects of aldosterone. Amongst others, it has been suggested that galectin-3 (Gal-3) is a key mediator in aldosterone-induced myocardial fibrosis. OBJECTIVE We studied whether patients with primary aldosteronism have higher plasma Gal-3 concentrations than patients with EHT and evaluated its reversibility after adrenalectomy. METHODS In a retrospective cohort from our tertiary referral centre, we measured plasma Gal-3 concentrations in 78 patients with primary aldosteronism, 39 cured primary aldosteronism patients after adrenalectomy and 56 patients with EHT. Paired samples were available in 11 patients (preadrenalectomy and postadrenalectomy). We compared plasma Gal-3 levels by univariate analysis of covariance with correction for cardiovascular risk factors, plasma creatinine concentration, plasma potassium levels and alcohol intake. RESULTS Adjusted plasma Gal-3 concentrations in patients with primary aldosteronism, patients after adrenalectomy and patients with EHT were 11.39 ± 0.60, 11.64 ± 0.81 and 11.41 ± 0.73 ng/ml, respectively (mean ± SD; P = 0.95). In 11 patients of whom paired samples were available, mean Gal-3 concentrations increased from 10.03 ± 1.67 ng/ml preadrenalectomy to 14.36 ± 2.07 ng/ml postadrenalectomy (P < 0.01). CONCLUSION In patients with primary aldosteronism, plasma Gal-3 concentrations are not elevated when compared with patients with EHT, and levels do not decrease after adrenalectomy. These results are in contrast to previous studies and do not support a pathophysiological role of plasma Gal-3 in the increased cardiovascular risk in patients with primary aldosteronism.
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW Recognition of subclinical myocardial dysfunction offers clinicians and patients an opportunity for early intervention and prevention of symptomatic cardiovascular disease. We review the data on novel biomarkers in subclinical heart disease in the general population with a focus on pathophysiology, recent observational or trial data, and potential applicability and pitfalls for clinical use. RECENT FINDINGS High-sensitivity cardiac troponin and natriuretic peptide assays are powerful markers of subclinical cardiac disease. Elevated levels of these biomarkers signify subclinical cardiac injury and hemodynamic stress and portend an adverse prognosis. Novel biomarkers of myocardial inflammation, fibrosis, and abnormal contraction are gaining momentum as predictors for incident heart failure, providing new insight into pathophysiologic mechanisms of cardiac disease. There has been exciting growth in both traditional and novel biomarkers of subclinical cardiac injury in recent years. Many biomarkers have demonstrated associations with relevant cardiovascular outcomes and may enhance the diagnostic and prognostic power of more conventional biomarkers. However, their use in "prime time" to identify patients with or at risk for subclinical cardiac dysfunction in the general population remains an open question. Strategic investigation into their clinical applicability in the context of clinical trials remains an area of ongoing investigation.
Collapse
Affiliation(s)
- Kamal Shemisa
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA
| | - Anish Bhatt
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA
| | - Daniel Cheeran
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA
| | - Ian J Neeland
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA.
| |
Collapse
|
29
|
Fashanu OE, Folsom AR, Oyenuga A, Ballantyne CM, Lutsey PL, Tang W. Galectin-3 and the incidence of abdominal aortic aneurysm: the atherosclerosis risk in communities (ARIC) study. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2017; 7:114-121. [PMID: 29348972 PMCID: PMC5768869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/12/2017] [Indexed: 06/07/2023]
Abstract
Galectin-3, a β-galactosidase binding lectin, known to be involved in inflammatory processes may be associated with abdominal aortic aneurysm (AAA) incidence. We examined the prospective association between plasma galectin-3 and incident AAA in 9,704 participants of the Atherosclerosis Risk in Communities (ARIC) study cohort. We followed participants from 1996-1998 through 2011 (124,260 person-years) for incident AAA (n=325) defined by ICD codes from hospital records and death certificates. At baseline, participants had a mean (SD) age of 62.8 (5.7) years; 20.9% were blacks and 56.5% females. The median (25th-75th percentile) galectin-3 level was 14.2 (12.0-16.9) ng/mL. Galectin-3 was correlated positively with most cardiovascular risk factors and with several cardiac or inflammatory biomarkers (C-reactive protein, troponin-T, and NT-proBNP). Using Cox proportional hazards regression adjusted for demographic variables and measured AAA risk factors, the hazard ratios for AAA across galectin-3 quintiles were 1 (Referent), 1.54 (1.05-2.26), 1.58 (1.05-2.41), 1.76 (1.15-2.72), and 1.92 (1.22-3.01) (p for trend =0.01). Further adjustment for the cardiac and inflammatory biomarkers largely attenuated the association between galectin-3 and AAA [AAA hazard ratio for galectin-3 Quintile 5 vs. Quintile 1: 1.29 (0.81-2.05); p-trend across quintiles =0.44]. In conclusion, higher concentrations of plasma galectin-3 were associated with greater incidence of AAA though not independent of other cardiac and inflammatory biomarkers. This reinforces that galectin-3, a systemic biomarker reflecting inflammation and probably increased systemic vascular resistance, is elevated early in the pathogenesis of AAA.
Collapse
Affiliation(s)
- Oluwaseun E Fashanu
- Division of Epidemiology & Community Health, School of Public Health, University of MinnesotaMinneapolis, Minnesota, USA
| | - Aaron R Folsom
- Division of Epidemiology & Community Health, School of Public Health, University of MinnesotaMinneapolis, Minnesota, USA
| | - Abayomi Oyenuga
- Division of Epidemiology & Community Health, School of Public Health, University of MinnesotaMinneapolis, Minnesota, USA
| | - Christie M Ballantyne
- Department of Medicine, Baylor College of Medicine and Methodist DeBakey Heart and Vascular CenterHouston, Texas, USA
| | - Pamela L Lutsey
- Division of Epidemiology & Community Health, School of Public Health, University of MinnesotaMinneapolis, Minnesota, USA
| | - Weihong Tang
- Division of Epidemiology & Community Health, School of Public Health, University of MinnesotaMinneapolis, Minnesota, USA
| |
Collapse
|
30
|
Di Tano G, Caretta G, De Maria R, Bettari L, Parolini M, Testa S, Pirelli S. Galectin-3 and outcomes after anterior-wall myocardial infarction treated by primary percutaneous coronary intervention. Biomark Med 2017; 12:21-26. [PMID: 29243525 DOI: 10.2217/bmm-2017-0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Galectin-3 (Gal-3), a biomarker of inflammation, tissue repair and fibrogenesis, is associated to left ventricular remodeling after ST-elevated myocardial infarction (STEMI), but its relation with long-term outcomes is unclear. METHODS In 103 consecutive patients with a first anterior STEMI treated by primary angioplasty, we assayed Gal-3 and NT-proBNP. RESULTS Age was 65 (56-76) years, 28% were women. During 18 ± 13 months, 20 patients (19.4%) died or were admitted for heart failure. After adjustment for age, gender, renal and ventricular function, troponin, NT-proBNP and Gal-3 independently predicted the combined end point (hazard ratio: 1.11; 95% CI: 1.05-1.17; per 1 ng/ml increase). Event-free survival was 42.3 versus 93.5% for Gal-3≥ versus <16.8 ng/ml (p < 0.001). CONCLUSION Among anterior STEMI patients, early postangioplasty Gal-3 levels may be useful for risk stratification.
Collapse
Affiliation(s)
- Giuseppe Di Tano
- Division of Cardiology, ASST - Hospital of Cremona, Cremona, Italy
| | - Giorgio Caretta
- Division of Cardiology, Sant'Andrea Hospital, ASL 5 Liguria - La Spezia, Italy
| | - Renata De Maria
- CNR Clinical Physiology Institute Cardiothoracic & Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy
| | - Luca Bettari
- Division of Cardiology, ASST - Hospital of Cremona, Cremona, Italy
| | - Marina Parolini
- CNR Clinical Physiology Institute Cardiothoracic & Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy
| | - Sophie Testa
- Division of Laboratory Medicine, ASST - Hospital of Cremona, Cremona, Italy
| | | |
Collapse
|
31
|
Nielsen SH, Mouton AJ, DeLeon-Pennell KY, Genovese F, Karsdal M, Lindsey ML. Understanding cardiac extracellular matrix remodeling to develop biomarkers of myocardial infarction outcomes. Matrix Biol 2017; 75-76:43-57. [PMID: 29247693 DOI: 10.1016/j.matbio.2017.12.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/02/2017] [Accepted: 12/08/2017] [Indexed: 01/08/2023]
Abstract
Cardiovascular Disease (CVD) is the most common cause of death in industrialized countries, and myocardial infarction (MI) is a major CVD with significant morbidity and mortality. Following MI, the left ventricle (LV) undergoes a wound healing response to ischemia that results in extracellular matrix (ECM) scar formation to replace necrotic myocytes. While ECM accumulation following MI is termed cardiac fibrosis, this is a generic term that does not differentiate between ECM accumulation that occurs in the infarct region to form a scar that is structurally necessary to preserve left ventricle (LV) wall integrity and ECM accumulation that increases LV wall stiffness to exacerbate dilation and stimulate the progression to heart failure. This review focuses on post-MI LV ECM remodeling, targeting the discussion on ECM biomarkers that could be useful for predicting MI outcomes.
Collapse
Affiliation(s)
- Signe Holm Nielsen
- Fibrosis Biology and Biomarkers, Nordic Bioscience, Herlev, Denmark; Disease Systems Immunology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Alan J Mouton
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kristine Y DeLeon-Pennell
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA; Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA
| | | | - Morten Karsdal
- Fibrosis Biology and Biomarkers, Nordic Bioscience, Herlev, Denmark
| | - Merry L Lindsey
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA; Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA.
| |
Collapse
|
32
|
Increased galectin-3 levels are associated with abdominal aortic aneurysm progression and inhibition of galectin-3 decreases elastase-induced AAA development. Clin Sci (Lond) 2017; 131:2707-2719. [PMID: 28982723 DOI: 10.1042/cs20171142] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 01/28/2023]
Abstract
Abdominal aortic aneurysm (AAA) evolution is unpredictable and no specific treatment exists for AAA, except surgery to prevent aortic rupture. Galectin-3 has been previously associated with CVD, but its potential role in AAA has not been addressed. Galectin-3 levels were increased in the plasma of AAA patients (n=225) compared with the control group (n=100). In addition, galectin-3 concentrations were associated with the need for surgical repair, independently of potential confounding factors. Galectin-3 mRNA and protein expression were increased in human AAA samples compared with healthy aortas. Experimental AAA in mice was induced via aortic elastase perfusion. Mice were treated intravenously with the galectin-3 inhibitor modified citrus pectin (MCP, 10 mg/kg, every other day) or saline. Similar to humans, galectin-3 serum and aortic mRNA levels were also increased in elastase-induced AAA mice compared with control mice. Mice treated with MCP showed decreased aortic dilation, as well as elastin degradation, vascular smooth muscle cell (VSMC) loss, and macrophage content at day 14 postelastase perfusion compared with control mice. The underlying mechanism(s) of the protective effect of MCP was associated with a decrease in galectin-3 and cytokine (mainly CCL5) mRNA and protein expression. Interestingly, galectin-3 induced CCL5 expression by a mechanism involving STAT3 activation in VSMC. Accordingly, MCP treatment decreased STAT3 phosphorylation in elastase-induced AAA. In conclusion, increased galectin-3 levels are associated with AAA progression, while galectin-3 inhibition decreased experimental AAA development. Our data suggest the potential role of galectin-3 as a therapeutic target in AAA.
Collapse
|
33
|
Fashanu OE, Norby FL, Aguilar D, Ballantyne CM, Hoogeveen RC, Chen LY, Soliman EZ, Alonso A, Folsom AR. Galectin-3 and incidence of atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study. Am Heart J 2017; 192:19-25. [PMID: 28938960 DOI: 10.1016/j.ahj.2017.07.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/03/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Galectin-3, a β-galactoside binding lectin involved in important regulatory roles in adhesion, inflammation, immunity, and fibrosis, may be relevant to atrial fibrillation (AF) etiology. METHODS We included 8,436 participants free of AF at baseline (1996-1998) and with measures of plasma galectin-3 from the Atherosclerosis Risk in Communities study. We ascertained incident AF through 2013 from study visit electrocardiograms, hospitalizations, and death certificates. Multivariable Cox proportional hazards models, adjusted for AF risk factors plus incident heart failure (HF) and coronary heart disease (CHD), were used to estimate hazard ratios for the association between galectin-3 and incident AF. RESULTS The mean age (SD) of participants was 62.6 (5.6) years, and the sample was comprised of 58.7% women and 21.2% blacks. During a median follow-up of 15.7 years, 1,185 incident cases of AF were observed. After adjusting for AF risk factors, participants with galectin-3 levels ≥90th percentile (19.5 ng/mL) had a significantly higher risk of incident AF when compared with the lowest quartile (4.4-11.9 ng/mL), with hazard ratios (95% CI) of 1.40 (1.04-1.89) for the 90th-<95th percentile and 1.51 (1.11-2.06) for the 95th-100th percentile. This association was attenuated and no longer statistically significant after accounting for incident CHD and HF as time-dependent variables. CONCLUSIONS Elevated plasma galectin-3 is associated with increased risk of incident AF. Galectin-3 may increase AF risk via pathways involving CHD and HF.
Collapse
Affiliation(s)
- Oluwaseun E Fashanu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - David Aguilar
- Department of Medicine, Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Christie M Ballantyne
- Department of Medicine, Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Ron C Hoogeveen
- Department of Medicine, Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston Salem, NC
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| |
Collapse
|
34
|
Fashanu OE, Heckbert SR, Aguilar D, Jensen PN, Ballantyne CM, Basu S, Hoogeveen RC, deFilippi C, Cushman M, Folsom AR. Galectin-3 and Venous Thromboembolism Incidence: the Atherosclerosis Risk in Communities (ARIC) Study. Res Pract Thromb Haemost 2017; 1:223-230. [PMID: 29152608 PMCID: PMC5685543 DOI: 10.1002/rth2.12038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The inflammatory biomarker galectin-3 contributes to pathologic conditions such as heart failure and stimulates murine thrombogenesis. Its association with venous thromboembolism (VTE) has been sparsely studied. Objectives To assess the prospective association of plasma galectin-3 and the LGALS3 rs4644 SNP with VTE incidence. Methods We measured plasma galectin-3 in 9,916 participants in the Atherosclerosis Risk in Communities (ARIC) study cohort in 1996 - 1998 and identified VTEs through 2013. Using Cox regression, we estimated the hazard ratio associating galectin-3 with incident VTE over a median of 13.9 years. Replication was sought in the Cardiovascular Health Study (CHS). Results ARIC included 21.8% blacks and 56.2% females with mean baseline age of 62.7 years. The incidence rate of VTE (n=389 events) increased across quintiles of galectin-3, with hazard ratios (95% CI) of 1 (reference), 1.13 (0.80 - 1.61), 1.00 (0.70 - 1.43), 1.36 (0.96 - 1.91), and 1.55 (1.09 - 2.19) (p-trend = 0.005), adjusted for age, sex, race, body mass index, diabetes status, and renal function. Results did not replicate in the CHS (124 VTE), but meta-analysis of both studies yielded a pooled hazard ratio (95% CI) for 1 SD increment in log galectin-3 of 1.10 (1.00 - 1.22). In ARIC, the C allele of rs4644 in the LGALS3 gene was associated with higher galectin-3 level, and in whites, with an increased rate of VTE. Conclusion Galectin-3 levels were associated positively with VTE incidence.
Collapse
Affiliation(s)
- Oluwaseun E Fashanu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - David Aguilar
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Paul N Jensen
- Cardiovascular Health Research Unit and Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Saonli Basu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ron C Hoogeveen
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Mary Cushman
- Division of Hematology/Oncology, Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
35
|
Koo JH, Cho JY. Erratum to: Treadmill Exercise Attenuates α-Synuclein Levels by Promoting Mitochondrial Function and Autophagy Possibly via SIRT1 in the Chronic MPTP/P-Induced Mouse Model of Parkinson's Disease. Neurotox Res 2017; 32:532-533. [PMID: 28741160 DOI: 10.1007/s12640-017-9779-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jung-Hoon Koo
- Department of Exercise Biochemistry, Korea National Sport University, Seoul, 138-763, Republic of Korea
- Institute of Sport Science, Korea National Sport University, Seoul, 138-763, Republic of Korea
| | - Joon-Yong Cho
- Department of Exercise Biochemistry, Korea National Sport University, Seoul, 138-763, Republic of Korea.
| |
Collapse
|
36
|
Seasonal and flight-related variation of galectin expression in heart, liver and flight muscles of yellow-rumped warblers (Setophaga coronata). Glycoconj J 2017; 34:603-611. [DOI: 10.1007/s10719-017-9779-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/25/2017] [Accepted: 05/28/2017] [Indexed: 10/19/2022]
|
37
|
Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment. Int J Mol Sci 2017; 18:ijms18050947. [PMID: 28468272 PMCID: PMC5454860 DOI: 10.3390/ijms18050947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/24/2017] [Accepted: 04/25/2017] [Indexed: 01/06/2023] Open
Abstract
Galectin-3 (Gal-3), a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV) dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF), being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS), affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment. Gal-3 levels were measured at admission in 80 consecutive patients with symptomatic degenerative AS (mean age: 79 ± 8 years; aortic valve area (AVA) index: 0.4 ± 0.1 cm²/m²). The therapeutic strategy was chosen following a dedicated multidisciplinary team-oriented approach, including surgical valve replacement (n = 11), transcatheter valve implantation (n = 19), balloon aortic valvuloplasty (BAV) (n = 25) and optimal medical therapy (n = 25). Besides routine echocardiographic indices, valvulo-arterial impedance (Zva), an index of global LV afterload, was computed. There were 22 deaths over a median follow-up of 523 days. Baseline Gal-3 correlated negatively with estimated glomerular filtration rate (eGFR) (r = -0.61, p < 0.001) and was unrelated to age, symptomatic status, AVA index, LV ejection fraction, LV mass index or Zva. For the study group as a whole, Gal-3 tended to predict mortality (Gal-3 >17.8 vs. Gal-3 <17.8 ng/mL; hazard ratio (HR): 2.03 (95% confidence interval, 0.88-4.69), p = 0.09), which was abolished upon adjustment for eGFR (HR: 1.70 (0.61-4.73), p = 0.3). However, in post-BAV patients multivariate-adjusted pre-procedural Gal-3 was associated with worse survival (HR: 7.41 (1.52-36.1), p = 0.01) regardless of eGFR. In conclusion, the inverse eGFR-Gal-3 relationship underlies a weak association between Gal-3 and adverse outcome in patients with degenerative AS referred for invasive therapy irrespective of type of treatment employed. In contrast, pre-procedural Gal-3 appears an independent mortality predictor in high-risk AS patients undergoing BAV.
Collapse
|
38
|
van der Velde AR, Meijers WC, van den Heuvel ER, Bakker SJ, van Gilst WH, van der Harst P, Hillege H, de Boer RA. Determinants of temporal changes in galectin-3 level in the general population: Data of PREVEND. Int J Cardiol 2016; 222:385-390. [PMID: 27505321 DOI: 10.1016/j.ijcard.2016.07.241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/14/2016] [Accepted: 07/29/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND High baseline galectin-3 levels are associated with increased risk for adverse cardiovascular outcomes in the general population, but determinants of changes in galectin-3 levels over time have not been established. Therefore, we aimed to identify determinants of (temporal) change in galectin-3 levels. METHODS Galectin-3 plasma levels were measured in a large community based cohort (PREVEND study) at 3 different time points: at baseline, after ~4 and ~9years. The association of baseline clinical and biochemical factors and (temporal) changes in galectin-3 level was assessed using multivariable mixed-effects regression modeling. RESULTS In 4355 subjects, galectin-3 plasma levels were available at all time points (mean age: 48±12years; 50% female). Median galectin-3 level at baseline was 10.7 [8.9-12.7] ng/mL which gradually increased to 11.5 [9.4-14.3] ng/mL after ~9years. Using mixed-effects regression modeling, we first validated as independent determinants of baseline circulating galectin-3: eGFR (chi square (χ(2)):210.27, p<0.0001), gender (χ(2):43.85; p<0.0001), BMI (χ(2):19.68, p=0.0001), NT-proBNP (χ(2):18.76, p=0.0001) and serum (total) cholesterol (χ(2):8.63, p=0.01). Furthermore, we identified urinary albumin excretion (χ(2):34.03, p-value: <0.0001) and systolic blood pressure (χ(2):16.81, p=0.002) as independent determinants of temporal changes of galectin-3. CONCLUSIONS In the general population, urinary albumin excretion >30mg/24h and systolic blood pressure >170mmHg were identified as significant determinants of dynamic increases in galectin-3 levels over time. These results implicate that treatment of high blood pressure might be effective to prevent increasing galectin-3 levels and its associated conditions.
Collapse
Affiliation(s)
- A Rogier van der Velde
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Wouter C Meijers
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Edwin R van den Heuvel
- Eindhoven University of Technology, Department of Mathematics and Computer Science, Eindhoven, The Netherlands
| | - Stephan J Bakker
- University of Groningen, University Medical Center Groningen, Department of Nephrology, Groningen, The Netherlands
| | - Wiek H van Gilst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Hans Hillege
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Rudolf A de Boer
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands.
| |
Collapse
|
39
|
Di Tano G, Caretta G, De Maria R, Parolini M, Bassi L, Testa S, Pirelli S. Galectin-3 predicts left ventricular remodelling after anterior-wall myocardial infarction treated by primary percutaneous coronary intervention. Heart 2016; 103:71-77. [PMID: 27465055 DOI: 10.1136/heartjnl-2016-309673] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/04/2016] [Accepted: 07/10/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Despite modern reperfusion therapies, left ventricular remodelling (LVR) occurs frequently after an ST-elevated myocardial infarction (STEMI) and represents a strong predictor of mortality and heart failure. Galectin-3 (Gal-3), a novel biomarker involved in inflammation, tissue repair and fibrogenesis, might be a valuable predictor of LVR. METHODS We enrolled consecutively admitted patients with a first anterior STEMI and left anterior descending artery occlusion treated by primary percutaneous coronary intervention (pPCI). Gal-3, N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography and cardiovascular events were evaluated 48 hours after admission, at 1 and 6 months. LVR was defined as a ≥15% increase in LV end-systolic volume. RESULTS We recruited 103 patients (28% women, aged 64.6±12 years, LV ejection fraction 47±11%). Median baseline Gal-3 and NT-proBNP levels were 13.2 ng/mL (10.8-17.1 ng/mL) and 2132 pg/mL (1019-4860 pg/mL) respectively. During 6 months of follow-up, 4 patients dropped out, 7 died and 26 (28.3%) of the 92 survivors developed LVR (LVR+). LVR+ patients had higher Gal-3 levels at baseline, 1 and 6 months than LVR- (p<0.0001). By univariable logistic regression, age, female gender, higher baseline Gal-3 and NT-proBNP, smaller LV end-diastolic volume (LVEDV) were associated to an increased risk of LVR. By multivariable analysis, only LVEDV (OR 0.96, 95% CI 0.93 to 0.99/1 mL change) and Gal-3 levels (OR 1.22, 95% CI 1.06 to 1.42/1 ng/mL change) independently predicted LVR (C-statistics 0.84, 95% CI 0.75 to 0.93). CONCLUSION Gal-3 serum levels measured during hospitalisation could be clinically useful in predicting LVR among patients admitted with anterior STEMI treated by pPCI.
Collapse
Affiliation(s)
- Giuseppe Di Tano
- Division of Cardiology, ASST-Hospital of Cremona, Cremona, Italy
| | - Giorgio Caretta
- Division of Cardiology, ASST-Hospital of Cremona, Cremona, Italy.,Division of Cardiology, Sant'Andrea Hospital, La Spezia, Italy
| | - Renata De Maria
- CNR Clinical Physiology Institute Cardiothoracic and Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy
| | - Marina Parolini
- CNR Clinical Physiology Institute Cardiothoracic and Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy
| | - Laura Bassi
- Division of Laboratory Medicine, ASST-Hospital of Cremona, Cremona, Italy
| | - Sophie Testa
- Division of Laboratory Medicine, ASST-Hospital of Cremona, Cremona, Italy
| | | |
Collapse
|