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

Edelmann, Frank ; Holzendorf, Volker ; Wachter, Rolf ; Nolte, Kathleen ; Schmidt, Albrecht G. ; Kraigher‐Krainer, Elisabeth ; Duvinage, André ; Unkelbach, Ines ; Düngen, Hans‐Dirk ; Tschöpe, Carsten ; Herrmann‐Lingen, Christoph ; Halle, Martin ; Hasenfuss, Gerd ; Gelbrich, Götz ; Stough, Wendy Gattis ; Pieske, Burkert M.

European Journal of Heart Failure, February 2015, Vol.17(2), pp.214-223 [Tạp chí có phản biện]

ISSN: 1388-9842 ; E-ISSN: 1879-0844 ; DOI: 10.1002/ejhf.203

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  • Nhan đề:
    Galectin‐3 in patients with heart failure with preserved ejection fraction: results from the Aldo‐DHF trial
  • Tác giả: Edelmann, Frank ; Holzendorf, Volker ; Wachter, Rolf ; Nolte, Kathleen ; Schmidt, Albrecht G. ; Kraigher‐Krainer, Elisabeth ; Duvinage, André ; Unkelbach, Ines ; Düngen, Hans‐Dirk ; Tschöpe, Carsten ; Herrmann‐Lingen, Christoph ; Halle, Martin ; Hasenfuss, Gerd ; Gelbrich, Götz ; Stough, Wendy Gattis ; Pieske, Burkert M.
  • Chủ đề: Galectin‐3 ; Heart Failure ; Diastolic ; Mortality ; Morbidity ; Spironolactone
  • Là 1 phần của: European Journal of Heart Failure, February 2015, Vol.17(2), pp.214-223
  • Mô tả: 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.
  • Số nhận dạng: ISSN: 1388-9842 ; E-ISSN: 1879-0844 ; DOI: 10.1002/ejhf.203

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