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Galectin-3 in patients with heart failure with preserved ejection fraction: results from the Aldo-DHF trial.
Eur J Heart Fail. 2015 Feb; 17(2):214-23.EJ

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.

Authors+Show Affiliations

Department of Cardiology and Pneumology, Heart Center, University of Göttingen, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), University of Göttingen, Göttingen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25418979

Citation

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, vol. 17, no. 2, 2015, pp. 214-23.
Edelmann F, Holzendorf V, Wachter R, et al. Galectin-3 in patients with heart failure with preserved ejection fraction: results from the Aldo-DHF trial. Eur J Heart Fail. 2015;17(2):214-23.
Edelmann, F., Holzendorf, V., Wachter, R., Nolte, K., Schmidt, A. G., Kraigher-Krainer, E., Duvinage, A., Unkelbach, I., Düngen, H. D., Tschöpe, C., Herrmann-Lingen, C., Halle, M., Hasenfuss, G., Gelbrich, G., Stough, W. G., & 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), 214-23. https://doi.org/10.1002/ejhf.203
Edelmann F, et al. Galectin-3 in Patients With Heart Failure With Preserved Ejection Fraction: Results From the Aldo-DHF Trial. Eur J Heart Fail. 2015;17(2):214-23. PubMed PMID: 25418979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Galectin-3 in patients with heart failure with preserved ejection fraction: results from the Aldo-DHF trial. AU - Edelmann,Frank, AU - Holzendorf,Volker, AU - Wachter,Rolf, AU - Nolte,Kathleen, AU - Schmidt,Albrecht G, AU - Kraigher-Krainer,Elisabeth, AU - Duvinage,André, AU - Unkelbach,Ines, AU - Düngen,Hans-Dirk, AU - Tschöpe,Carsten, AU - Herrmann-Lingen,Christoph, AU - Halle,Martin, AU - Hasenfuss,Gerd, AU - Gelbrich,Götz, AU - Stough,Wendy Gattis, AU - Pieske,Burkert M, Y1 - 2014/11/24/ PY - 2014/07/22/received PY - 2014/10/08/revised PY - 2014/10/10/accepted PY - 2014/11/25/entrez PY - 2014/11/25/pubmed PY - 2015/12/17/medline KW - Diastolic KW - Galectin-3 KW - Heart failure KW - Morbidity KW - Mortality KW - Spironolactone SP - 214 EP - 23 JF - European journal of heart failure JO - Eur. J. Heart Fail. VL - 17 IS - 2 N2 - 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. SN - 1879-0844 UR - https://www.unboundmedicine.com/medline/citation/25418979/Galectin_3_in_patients_with_heart_failure_with_preserved_ejection_fraction:_results_from_the_Aldo_DHF_trial_ L2 - https://doi.org/10.1002/ejhf.203 DB - PRIME DP - Unbound Medicine ER -