Galectin-3 in patients with heart failure with preserved ejection fraction: Results from the Aldo-DHF trial

Edelmann F, Holzendorf V, Wachter R, Nolte K, Schmidt AG, Kraigher-Krainer E, Duvinage A, Unkelbach I, Duengen HD, Tschoepe C, Herrmann-Lingen C, Halle M, Hasenfuss G, Gelbrich G, Stough WG, Pieske BM (2015)

Publication Type: Journal article

Publication year: 2015

Journal

European Journal of Heart Failure Oxford University Press (OUP): Policy B

Book Volume: 17

Pages Range: 214-223

Journal Issue: 2

DOI: 10.1002/ejhf.203

Abstract

Aims: Galectin-3 is a marker of myocardial fibrosis and mediates aldosterone-induced cardiovascular inflammation and fibrosis. Characteristics of galectin-3 and its response to spironolactone have not been evaluated in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to determine the association between galectin-3 levels and patient characteristics in HFpEF; to evaluate the interaction between spironolactone and galectin-3 levels; and to assess the association between galectin-3 and clinical outcomes. Methods and results: Aldo-DHF investigated spironolactone 25 mg once daily vs. placebo for 12 months in patients with NYHA class II-III, LVEF ≥50%, grade ≥ I diastolic dysfunction, and peakVO2 ≤ 25 mL/kg/min. Galectin-3 levels were obtained at baseline, and at 6 and 12 months. The association between baseline galectin-3, change in galectin-3, and all-cause death or hospitalization was evaluated, and the interaction between galectin-3 and treatment was assessed. Median baseline galectin-3 was 12.1 ng/mL. After multivariable adjustment, baseline galectin-3 inversely correlated with peak VO2 (P = 0.021), 6 min walk distance (P = 0.002), and Short Form 36 (SF-36) physical functioning (P = 0.001), and directly correlated with NYHA class (P = 0.007). Baseline NT-proBNP correlated with E/e' velocity ratio (P ≤ 0.001), left atrial volume index (P < 0.001), and LV mass index (P = 0.009). Increasing galectin-3 at 6 or 12 months was associated with all-cause death or hospitalization independent of treatment arm [hazard ratio (HR) 3.319, 95% confidence interval (CI) 1.214-9.07, P = 0.019] and NT-proBNP (HR 3.127, 95% CI 1.144-8.549, P = 0.026). Spironolactone did not influence galectin-3 levels. Conclusion: Galectin-3 levels are modestly elevated in patients with stable HFpEF and relate to functional performance and quality of life. Increasing galectin-3 was associated with worse outcome, independent of treatment or NT-proBNP.

Involved external institutions

Georg-August-Universität Göttingen DE Germany (DE) Universität Leipzig DE Germany (DE) Technische Universität München (TUM) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE) Campbell University US United States (USA) (US)

How to cite

APA:

Edelmann, F., Holzendorf, V., Wachter, R., Nolte, K., Schmidt, A.G., Kraigher-Krainer, E.,... Pieske, B.M. (2015). Galectin-3 in patients with heart failure with preserved ejection fraction: Results from the Aldo-DHF trial. European Journal of Heart Failure, 17(2), 214-223. https://doi.org/10.1002/ejhf.203

MLA:

Edelmann, Frank, et al. "Galectin-3 in patients with heart failure with preserved ejection fraction: Results from the Aldo-DHF trial." European Journal of Heart Failure 17.2 (2015): 214-223.

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