Galectin-3 in patients with chronic heart failure: association with oxidative stress, inflammation, renal dysfunction and prognosis.

Background: Galectin-3 is a recently developed biomarker of fibrosis, which may play a role in cardiac remodeling and associated with both the progression and severity of heart failure (HF).

Methods: A prospective cohort study of 190 patients with documented prior myocardial infarction and chronic HF (NYHA class II-IV) was conducted. Patients were divided into 3 groups based on their NYHA functional class. Levels of galectin-3, NT-proBNP, CRP, IL-6, oxidized-LDL, extracellular superoxide dismutase (EC-SOD), 3-nitrotyrosine, SH-groups, cystatin-C were determined. Follow-up period was 26 months, and all-cause mortality was determined as the primary endpoint. Statistical analysis was performed and statistical significance was set at P<0.05.

Results: The cytokines hs-CRP, IL-6 and markers of oxidative stress had significant positive correlation with plasma galectin-3 levels in all groups of patients. The level of galectin-3 was significantly different between the groups (P<0.05). Galectin-3 was found to be the most sensitive and specific value in determination of 26 months mortality in patients with chronic HF. Logistic regression analysis showed that age, galectin-3 and cystatin-C were associated with death during the follow up period.

Conclusions: Galectin-3 levels are elevated in patients with chronic HF across all NYHA functional classes. Galectin-3 shows positive correlation with markers of oxidative stress, inflammation and kidney dysfunction. Galectin-3 levels and cystatin-C levels are independent predictors of 26-month mortality in patients with chronic HF. Patients with cystatin-C level >2800 pg/mL carry a worse prognosis. Galectin-3 level >21 ng/mL associated with increased mortality.